June 19, 2018

Billions of T-Cells Clear Woman's Breast Cancer in Study

05 June 2018, 11:05 | Winifred Adams

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

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

Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient's risk.

It's the largest study ever done about breast cancer treatment, and its main finding is that at least 70% of early-stage breast cancer patients may be spared chemotherapy; welcome news to those who've experienced it.

"The impact is tremendous", said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in NY.

Alan Melcher, professor of translational immunotherapy at the Institute of Cancer Research in London, who was not involved in the study said: "The work shows that even cancers like breast cancer, which don't have many antigens, are amenable to this sort of treatment".

The study was funded by the National Cancer Institute, some foundations and proceeds from the US breast cancer postage stamp.

The New England Journal of Medicine published a study on Sunday that examined a popular genetic test that estimated cancer risk based on nearly two dozen genes linked with the recurrence of breast cancer, according to CNN. (That mouthful refers to three things: that the cancer was found early, that it could bind to certain hormones and that it didn't have the HER2 receptor.) This type of breast cancer is the most common type, according to the researchers.

After enrolling for new trial in 2015, doctors in the United States adopted an experimental approach combining two different forms of immunotherapy after conventional hormone treatments and chemotherapy failed.

Over the years, the Cancer Institute has used its $59.8 million in proceeds for studies trying to improve early detection and to determine which cancers are most unsafe and need heaviest treatment and which are less so.

Researchers say, the results allowed them to separate women who would benefit from chemotherapy due to a higher risk of recurrent breast cancer, and those who tested at a lower risk and do not need chemo for treatment.

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The usual treatment is surgery followed by years of a hormone-blocking drug.

A group of metastatic breast cancer experts has urged policymakers to empower patients with greater choice and participation in their treatment and care, to improve the quality of life of patients, their carers and families.

However, there was unclear evidence on whether those who fall in between - the vast majority of patients - needed chemotherapy. Those at high risk are advised to receive it but intermediate was a toss-up until this study.

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

The test randomized women with intermediate risk, about 67 percent.

"Two people said she should get chemotherapy while two others said she should not". Survival was similar in both groups, with over 9 in 10 women still alive 9 years after treatment. Endocrine therapy, such as tamoxifen, is more important with this disease than chemotherapy, said Otis Brawley, chief medical and scientific officer for the American Cancer Society.

Oncotype DX first hit the market in 2004.

The 21-gene test has been used since 2003. At least 30-40 per cent patients, to whom we advice Oncotype DX, come in this score range. For patients with scores above 26, doctors always recommend chemotherapy. Globally, the most recent figures are from 2012, when there were 1.7 million new cases and more than half a million deaths.

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