Breast cancer gene test could spare some women chemo

Phyllis Laccetti a participant in the TailorX breast cancer study at her home in Ossining NY

According to first author Joseph Sparano of Montefiore Medical Center in NY, "any woman with early-stage breast cancer 75 or younger should have the test and discuss the results" with her doctor.

Patients, aged 18 to 75, were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone.

The study was funded in part by the proceeds from sales of the breast cancer postage stamp.

The results from the phase 3 TAILORx study were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, and are published in The New England Journal of Medicine. While lymph nodes in the axilla (armpit) are the most commonly affected, and are usually treated with surgery or radiation, the cancer may spread into lymph nodes behind the breast bone - called internal mammary (IM) lymph nodes - and then to those above the collar bone - called medial supraclavicular (MS) lymph nodes. The presence of hormone receptors in these tumours means that they respond to hormone therapy. If chemotherapy is used now, it's often used in lower doses and for shorter periods.

Lead investigator Steven Rosenberg said: "Because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer".

"We have been waiting for these results for years", said Allison Kurian, an oncologist at Stanford University who wasn't involved in the trial. The study confirmed that using a 21-gene analyzation to assess cancer recurrence risk can successfully indicate whether or not a woman needs to undergo invasive and unnecessary chemotherapy treatment. Treatment options include estrogen-blocking drugs along with doses of chemotherapy to lower the risk of recurrence. The results showed that the chemo made no significant difference at all in which women died from their cancer (about 6 percent for both groups) and which didn't go into remission (about 16 percent for both groups).

The life of a woman with terminal breast cancer has been saved by a pioneering new therapy, say USA researchers.

About 17 percent of the women tested had high-risk scores and were advised to have chemotherapy.

Other experts said the results confirm what many patients and doctors are already doing.

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. But although Mall returned to health soon after her surgery and remains cancer-free today, she said she was haunted by the uncertainty of her decision. However, there was a range between favourable and unfavourable where it was not clear whether we should give chemotherapy. They could potentially encourage patients to incorrectly avoid or stop treatment - with potentially tragic consequences. Globally, the most recent figures are from 2012, when there were 1.7 million new cases and more than half a million deaths. "There are some people who say, 'I don't care what you say, I'm never going to do chemo, '" and won't even have the gene test, she said. Well, a groundbreaking new study says that doesn't need to be the case.

"I was a little relieved". "I had a tumour in my chest that I could feel shrinking", she said.

For the treatment, the doctors, first cut small pieces of tissue from her tumor and studied it.

The scientists screen the patient's white blood cells and extract those capable of attacking the cancer.

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