Chemo 'unnecessary' for thousands with breast cancer

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

A leading oncologist said the findings will lead to a "fundamental change" in how the disease is treated.

Physicians are hailing the study as a major breakthrough that will help women avoid the devastating side-effects of chemo which include hair loss, infertility, pain, and possibly death.

Judy Perkins is the first woman in the world to have her breast cancer completely eradicated using a technique to turbocharge her immune system.

Sunday's results came from a federally sponsored trial called TailorX, which was created to help doctors more precisely tailor treatments for early-stage breast cancer.

"I'm delighted", said Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society, who was not part of the study.

"Hopefully lead us to a more molecular based treatment of breast cancer so eventually patients not need surgery or radiation instead take a pill from medicine and cure breast cancer", said Figueredo.

Bottom line: Figueredo said the study found approximately 70 percent of women with that type of cancer do not need chemo therapy.

The TAILORx trial used the Oncotype DX test, now available on the NHS, which allows doctors to predict the likelihood of the breast cancer returning.

Patients scoring 26 or higher on the scale do benefit and receive chemotherapy. They represent roughly half of the more than 17,000 new cases of breast cancer diagnosed in Australia every year.

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"These data confirm that using a 21-gene expression test to assess the risk of cancer recurrence can spare women unnecessary treatment if the test indicates that chemotherapy is not likely to provide benefit", lead author Dr. Joseph A. Sparano, associate director for clinical research at the Albert Einstein Cancer Center, said in a statement.

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

What is less clear is whether chemotherapy will be of any benefit to the majority of patients who have a mid-range recurrence score.

"To know there is something that is going to help other breast cancer patients not have to go through what I went through for that time period". "I've been anxious for a long time about unnecessary treatment for cancer, and unnecessary side effects from chemotherapy". It's called the Oncotype DX test.

In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the USA, along with 63,960 new cases of non-invasive (in situ) breast cancer. To conduct the study, women in the intermediate groups were either prescribed chemotherapy or given treatment absent of the use of chemotherapy. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is created to block the cancer-spurring effects of hormones. For those people, the side effects of chemotherapy could have been avoided, without making the treatment any less effective. Mrs Perkins said she left her job and "was planning on dying".

Overall survival was also higher in the group given this radiation treatment (73.2%) compared to control patients (70.8%).

To find the answer, researchers randomly assigned more than 6,700 women with intermediate scores - 11 to 25 - to two groups.

This could affect up to 70,000 women a year in the US and many more worldwide, the study noted. Exploratory analyses did suggest that the addition of chemotherapy was associated with some benefit for women 50 years of age or younger who had a recurrence score of 16 to 25, but not for those whose score 15 or lower.

"Oncologists have been getting much smarter about dialing back treatment so that it doesn't do more harm than good", Steven Katz, a University of MI researcher who examines medical decision-making, told the Washington Post.

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