Published: Fri, June 08, 2018
Medicine | By Douglas Stevenson

Most Women with Early Breast Cancer Do Not Benefit From Chemotherapy

Most Women with Early Breast Cancer Do Not Benefit From Chemotherapy

"Breast cancer is the most common cancer in women in the United States and worldwide", note the study authors.

"The impact is tremendous", said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in NY. "There are a number of men and women who say, 'I really don't care what you say, I am never likely to do chemo, '" and won't have the gene evaluation, she explained.

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

The results of the study were presented on Sunday in Chicago at the American Society of Clinical Oncology meeting. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.

Chang said the results were exciting because chemotherapy before surgery has been adopted in other cancer types, such as breast and large bowel, and this study now provides evidence to suggest benefit for pancreatic cancer too. But it is only for early stage breast cancers that can still be treated with hormone therapy, have not spread to the lymph nodes, and do not have the HER2 mutation.

The hormone treatment is usually taken for between five to 10 years after surgery.

10,273 women were involved in trials of a genetic breast cancer test, performed on a tumour sample removed during surgery, which analyses the activity levels of 21 genes, which are markers of how aggressive the cancer is.

Approximately 17 percent of girls needed high-risk scores and have been counseled to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.

Of those, 67% (6,711) received scores of 11 to 25 on the gene test, which indicated an intermediate risk of cancer recurrence. Women who get their mammograms on time have a much better chance of being diagnosed in the earlier stages and therefore a less likelihood of needing chemo. At nine years, the rate was 83.3 percent for those with hormone therapy alone and 84.3 percent for the group that had both therapies.

While overall survival was small in the study because the patients were so ill to start with, the scientists behind it said the relative benefit of matched therapy applies to all cancer patients. Fleener says it's all part of the ongoing project to treat and cure breast cancer. "And this is the promise of personalized medicine, and it's arrived", Agus said.

"We believe that this may be a practice-changing trial", said Dr. Geertjan Van Tienhoven, from the Department of Radiation Oncology, Academic Medical Center in Amsterdam. The money was used to pay for the gene test, which costs more than $4,000 per person.

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