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'Remarkable' therapy beats terminal breast cancer

07 June 2018
'Remarkable' therapy beats terminal breast cancer

A major new cancer trial involving Irish women has found that chemotherapy can be avoided in 70% of women with the most common type of early stage breast cancer.

Scientists used the Oncotype Dx test to predict how likely hormone receptor positive breast cancer was to come back after surgery.

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

According to a new USA study, after the tumor has been removed from the breast, chemotherapy would only be needed in 20% of cases for patients suffering of breast cancer.

According to Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, "Breast surgeons and oncologists have been using the 21-gene assay for years to guide treatment after surgical excision".

A new class of patients could soon be treated for breast cancer, no chemotherapy required.

Funded by the National Cancer Institute, various foundations and proceeds from the breast cancer research stamp, the study is the largest ever done on breast cancer treatment.

He told the BBC: "We think this is a remarkable result".

He pointed out that by having this trial in Ireland, this has allowed more personalised treatment recommendations for women with this type and stage of breast cancer.

"It's also highly significant that this outcome suggests reprogramming patients' immune cells as part of a two-pronged attack could be a viable way to treat ER-positive tumours - which could open this approach up to benefit many patients with metastatic breast cancer".

Past experiments revealed that one group of people particular results of the genetic test would benefit from a combination of endocrine therapy and chemotherapy. This left a lot of women, an estimated 65,000 in the US each year, in a gray zone, unsure if they would benefit from chemo.

The trial is due to enrol around 330 patients to fully put the technique through its paces, and should be able to generate statistically-validated results in 2023.

It enrolled 10,273 United States women with HR+HER2-AN- breast cancer, which accounts for 23,000 of the 55,000 diagnoses in the UK each year. "But we need to be precise on when to use it and who to recommend it to". This therapy has allegedly been an essential treatment for many women as it lowers the risk of cancer recurrence, new tumors from appearing, and even death from the disease.

"The study should have a huge impact on doctors and patients", said Dr Kathy Albain, one of the main co-authors. Previous studies demonstrated that patients with scores of 10 or less did not need chemotherapy, while women with scores above 25 did benefit from it.The new study examined the majority of women who fall in the intermediate range of 11 to 25. "I had a tumour in my chest that I could feel shrinking", she said.

So the biggest unanswered questions involved women in the intermediate-risk category: Did chemo reduce their chance of recurrence?

Researchers share preliminary and more advanced results.

"Tumors grow more aggressively in premenopausal women, not just women under 50", Brawley said.

As of January 2018, there are more than 3.1 million women with a history of breast cancer in the U.S. This includes women now being treated and women who have finished treatment. "After the treatment dissolved most of my tumours, I was able to go for a 40-mile hike", she added.

That doctors and researchers need to constantly re-evaluate the assumptions on which medical decisions are based, especially for something as important and time-sensitive as cancer treatments.