Published: Tue, June 05, 2018
Medicine | By Douglas Stevenson

Study shows most breast cancer patients can skip chemotherapy

Study shows most breast cancer patients can skip chemotherapy

The study began in 2006 and included more than 10,000 women.18 of those women were patients from Sparrow Hospital and doctors there say this is a major discovery because roughly 250,000 women are diagnosed with breast cancer every year in America, but based of this study, up to 70,000 of those women will not need to go through any sort of chemotherapy treatment.

"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 case with other TIL therapies in the past is that they've not been able to expand enough T cells in many patients, there aren't enough to start with".

The same decade-long study had previously confirmed that patients at low risk, as determined by a genomic test of their tumors, can skip chemotherapy. 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).

This means thousands of women will be able to avoid all of the side effects chemotherapy implies, such as nausea, vomiting, hair loss and fatigue, while still achieving positive long-term outcomes.

The entire treatment was based on the woman's own antibodies.

Chemo and hormone therapy didn't work but this one-time treatment with more personalized immunotherapy did work for Perkins.

Across the European Union, we have seen positive results for breast cancer care as more women are being diagnosed and treated earlier, leading to higher survival rates.

The TAILORx trial used the Oncotype DX test, which is available on the NHS and which allows doctors to predict the likelihood of the breast cancer returning. Those who score 26 or higher on the scale do benefit and now receive chemotherapy.

In this study, nearly 7,000 women had scores between 11 and 25.

Patients with a recurrence score of up to 10 out of 100 have been shown not to benefit from chemotherapy and only hormone treatment is required. Despite seven types of chemotherapy and hormonal therapy, her disease was still growing. Some women 50 or younger, however, did see benefits from chemo.

Judy Perkins, 49, had been given three months to live, but two years later there is no sign of cancer in her body.

"Two people said she should get chemotherapy while two others said she should not".

She had tennis ball-sized tumours in her liver and secondary cancers throughout her body. "It was all gone", she said. "My brother was so sick that he'd be saying, 'I can't do this anymore, ' and it was the same thing with my sister". The cancer has not returned. Because of that, many women with early-stage cancer used to be urged to get chemotherapy in hopes of preventing any spread. Oncotype DX costs around $4,000, which Medicare and many insurers cover.

Yet the move away from chemotherapy has been hotly debated, with some doctors warning that chemo can save lives and that a "de-escalation" of treatment could be unsafe.

Dr Steven Rosenberg, chief of surgery at the National Cancer Institute, which led the trial, told the broadcaster that the therapy remained "highly experimental", but had the potential to transform cancer treatment.

He added that it was important that the federal government funded the study because the pharmaceutical industry has little interest in sponsoring trials that result in a reduction of treatment.

Experts have described the study as fascinating and exciting even though it reported on just one patient.

"We are getting better all the time", said Rosenberg, whose findings are published in the journal Nature Medicine.

These results provide assurance that getting gene tested is a valuable first step for patients with this type of breast cancer. A patient's immune system will already be attacking the tumour, it's just losing the fight between white blood cells and cancer.

Judy - who lives in Florida - had spreading, advanced breast cancer that could not be treated with conventional therapy.

"The treatment sometimes makes you sicker than the disease", Tuttle said.

The second study tested a form of immunotherapy against chemo, in the most common lung cancer worldwide, known as non-small-cell lung cancer. "We want to give the right amount", he said.

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