Many breast cancer patients can skip chemo, new study finds

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

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

Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society said that he was "delighted" by the study and anxious about unnecessary cancer treatment and the side effects that come from chemotherapy.

"You shouldn't do chemo unless you have to", added Dr. Jack Jacoub, medical oncologist and medical director at the MemorialCare Cancer Institute at the Orange Coast Medical Center in California.

Proceeds from the U.S. Postal Service's breast cancer stamp helped fund this important study.

Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute, was stunned by the response shown by Perkins' body, who had resigned herself to what she thought would be her inevitable end. "With your help, we can continue to support a better informed local community and a healthier democracy for another 30 years". To conduct the study, women in the intermediate groups were either prescribed chemotherapy or given treatment absent of the use of chemotherapy.

The treatment involves a highly personalized approach and a patient's tumor is genetically analyzed to "identify the rare changes that might make the cancer visible to the immune system".

These mid-range women were randomly assigned to either receive hormone therapy alone, or hormone therapy and chemotherapy. "If we are going to take a step back" from chemotherapy, he said, "we really had to be sure". Now they can have confidence in those decisions, experts said. The test looks for 21 specific genes associated with breast-cancer remission.

"We have been waiting for these results for years", said Allison Kurian, an oncologist at Stanford University who wasn't involved in the trial.

In Canada, where one in eight women will develop breast cancer, many doctors are hoping to use the study's findings to change how they treat the disease.

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The study enrolled 10,273 women, of whom 9719 with follow-up data were included in the main analysis set; 6711 women (69%) had an intermediate recurrence score of 11-25, while 1619 (17%) had a low recurrence sore of 10 or less and 1389 (14%) had a recurrence score of 26 or higher.

Breast cancer is the most common form of cancer among women in the world, and hormone-receptor-positive, HER2-negative, node-negative cancer constitutes about half of the 1.7 million cases diagnosed yearly worldwide. "I had a tumour in my chest that I could feel shrinking", she said.

Sparano noted that given the several variations of endocrine therapy now available, women who have trouble tolerating one should try another.

"The study should have a huge impact on doctors and patients", Dr. Kathy Albain, a hematologist/oncologist at Loyola Medicine in IL and a study co-author, said in a press release.

The phase III clinical trial, named "TAILORx", followed over 10,000 women diagnosed with breast cancer between 2006 and 2010. They also have a score between 11 and 25 on the Oncotype DX Breast Recurrence Score test.

For many patients, it's a hard choice to decide whether to go through chemotherapy.

"Tumors grow more aggressively in premenopausal women, not just women under 50", Brawley said. Another 16 per cent had very low risk scores and were told they could skip chemo.

The team of doctors complemented the cell treatment with "a range of new immunotherapy drugs called "checkpoint inhibitors", Sky News reports, "designed to overcome a cancer's ability to shield itself from the immune system".

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