Health Care

Gene test shows more breast cancer patients can skip chemo

Gene test shows more breast cancer patients can skip chemo”

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.

Peter Johnson, an oncology professor at the Cancer Research UK Centre, said the study confirmed the immune system can recognise some cancers, and "if this can be stimulated in the right way, even cancers that have spread to different parts of the body may be treatable".

"I anxious that there were cancer cells left over in my body that were spreading everywhere because I didn't have the systemic treatment", Mall recalled.

No two breast cancers are identical, but we've always been able to group them according to certain characteristics that, in turn, have been used by doctors to choose a mix of available treatments with the greatest chance of success.

For example, another study at the conference found that Merck's immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.

However, the results of the TAILORx trial show that only 30pc of women with this particular form of early-stage breast cancer benefit from the treatment.

Irish oncologists have been giving progressively less chemotherapy to low risk women as evidence emerged in recent years.

The breast cancer study focused on cases where chemo's value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets. The test looks for 21 specific genes associated with breast-cancer remission. "So we have two yes-no answers for each gene".

The naturally-occurring immune cells are then multiplied over and over again in a lab, before being injected back into the patient, where they can get to work.

That's why it's great news to hear that doctors in the USA have just made an wonderful scientific breakthrough through, curing a woman who was in the advanced stages of the disease. Simply put, the side effects are frightful: In addition to nausea, vomiting, hair and weight loss, chemo drugs can damage the heart and nervous system, and in rare cases, even cause different types of cancer. Longer-term effects of chemotherapy include infertility and heart failure.

The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs. Those with recurrence scores of 16 and above got a "substantial" benefit from chemotherapy and should consider it, said lead author Joseph Sparano, associate director for clinical research at the Albert Einstein Cancer Center and Montefiore Medical Center. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is created to block the cancer-spurring effects of hormones. At the end of that time they found 83.3% of those on hormone therapy alone had not developed a recurrence or a second primary cancer.

The overall survival rate was similar: 93.9% for those who received hormone therapy alone and 93.8% for those who received both therapies. "Now, we're not going to have to have that long discussion", she says.

But there is a note of caution in interpreting the study's findings. Based on the pattern in which these genes are turned either on or off, the test produces a score between 0 and 100, which measures the woman's risk of developing breast cancer again in the future.

Women can have the tendency to turn towards chemo, even if the results have a relatively small benefit, Albain says.

"Tumors grow more aggressively in premenopausal women, not just women under 50", Brawley said. Or was it sufficient for them to be treated only with endocrine therapy, which blocks the cancer-spurring properties of hormones?



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