Published: Wed, June 06, 2018
Medical | By Garry George

Many women with early breast cancer may not need chemo, study finds

Many women with early breast cancer may not need chemo, study finds

The results are sure to accelerate the decline in chemotherapy for the disease.

Using the breast cancer test, which looks at the activity of genes, the test found that more women with lower scores will not require chemotherapy.

What will she tell women who under prior guidelines received chemo and all its side effects and didn't need it after all?

"For countless women and their doctors, the days of uncertainty are over". But many women also are urged to have chemo to help kill any stray cancer cells. The gene test results are measured on a scale of 0-26. Should we give them chemotherapy? Now they can have confidence in those decisions, experts said. But it can fail, often because it cannot recognise cancer cells containing the patient's own DNA.

Previous trials involving cancer immunotherapy have found that it "tends to work spectacularly for some patients, but the majority do not benefit", the BBC reports. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine.

The big outstanding question was: What should women with "midrange" scores get?

Dr Steven Rosenberg, a leading member the medical team, said: "This patient came to us in a desperate situation, with every treatment having failed".

Through genetic testing, they separated women more likely to have recurrent cancer, which could potentially spare thousands from the treatment.

"Its findings will greatly expand the number of patients who can forgo chemotherapy without compromising their outcomes". This left a lot of women, an estimated 65,000 in the US each year, in a gray zone, unsure if they would benefit from chemo. "[The findings] are both important and significant, and also practice-changing", says, Dr. José Baselga, a medical oncologist and physician in chief at Memorial Sloan Kettering Cancer Center in NY, who was not involved with this research.

The cancer had spread to various parts of her body, including the liver. She had a lumpectomy, followed by a mastectomy, and had a recurrence score of 12 or 13, which put her in the middle range. Chemotherapy could still be on the table for people who fall outside of this group. She got only tamoxifen.

An early form of adoptive immunotherapy, called CAR-T therapy, exhibited severe side effects across many of its clinical trials, including some deaths.

She is the principal investigator for the Cancer Research Consortium of West Michigan, an organization that works with hospitals across the region to conduct research trials for cancer patients.

"They told me they had treated 12 patients and were following up on one", she said. "My brother was so sick that he'd be saying, 'I can't do this anymore, ' and it was the same thing with my sister". The cancer has not returned.

Research has shown that Oncotype Dx and other tests, including Breast Cancer Index and EndoPredict, vary in accuracy, particularly when predicting the long-term risk of someone's cancer coming back.

Baroness Delyth Morgna, chief executive of Breast Cancer Now, said: "We hope these practice-changing findings will now help refine our use of chemotherapy on the NHS". The TAILORx trial was created to help personalize treatment for women 18 to 75 years of age with hormone receptor (HR)-positive, HER2-negative, axillary node (AN)-negative breast cancer whose tumors were 1.1 cm to 5.0 cm in size and who had a mid-range RS.

They also have a score between 11 and 25 on the Oncotype DX Breast Recurrence Score test, a test that measures cancer recurrence.

"Chemotherapy has saved a tremendous amount of lives, and will continue to do so", Baselga says. Kymriah, for young patients with a type of blood and bone marrow cancer, was initially costed at almost half a million United States dollars per treatment. Tuttle was diagnosed with breast cancer last August.

Patients with a recurrence score of up to ten out of 100 have previously been shown not to benefit from chemotherapy and need only hormone treatment.

While chemotherapy is being dropped for some cases, it's being increased for more aggressive cancers. "No more, no less".

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