Chemo not needed in some early breast cancer patients

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In a comment also published by Nature Medicine, expert Laszlo Radvanyi from Canada's Ontario Institute for Cancer Research said the woman's response to the treatment was "unprecedented" for such advanced breast cancer.

A woman with late-stage breast cancer that had spread throughout her body is now completely clear of the disease, thanks to a treatment that used her own immune cells to destroy the cancer.

According to the study, more than 20,000 women in the United Kingdom are diagnosed with hormone-receptor positive, HER2-negative, node-negative breast cancer annually.

Dr Simon Vincent, director of research at the charity Breast Cancer Now, warned more patients will have to be treated to assess how effective the therapy is.

All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society.

While chemo can be greatly helpful to some patients, it has a significant number of drawbacks and serious side effects.

The new study, called TAILORx, is a large, randomized trial involving thousands of patients.

In a media release, Genomic Health, who makes the Oncotype DX Breast Recurrence Score test, said it provided funding for collection of follow-up information from the treating sites, but was not involved in the planning and execution of the study.

Many doctors have been using that test or similar ones for years. Importantly, chemotherapy still showed some benefit in women with higher Oncotype recurrence scores, and in some women under the age of 50.

"This life-changing breakthrough is absolutely wonderful news as it could liberate thousands of women from the agony of chemotherapy".

"This is something cancer doctors have struggled with", he said.

Specifically, the overall survival rate is 93.9 percent for those who received hormone therapy alone and 93.8 per cent for those who received both therapies.

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While previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, and women with high scores (above 25) did require and benefit from chemotherapy, there was no conclusive research guiding patients and doctors on whether or not to undergo chemotherapy in cases with a tumour with a mid-range score, according to the study.

"But there is a caveat, that these findings only apply to a particular subset of women."

Women aged 50 or younger were the notable exception. Whether or not to have the treatment is a bad dilemma for many women with certain types of breast cancer as they often don't have clear-cut answers on the benefits.

"For countless women and their doctors, the days of uncertainty are over".

For example, another study at the conference found that Merck's immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.

The team is now using the same approach to try to treat patients with advanced liver cancer and colorectal.

About 41,000 women and 465 men died from the disease that year.

The subset of breast tumours that form the focus of this study are driven by hormones (oestrogen), do not respond to drugs such as trastuzumab (also known as Herceptin - an engineered antibody that targets HER2), and haven't yet spread to the lymph nodes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, "but it was over fairly quickly and I'm really glad I had it".

Gilead's Kite unit signed a development agreement for the experimental therapy, Rosenberg said.

If doctors had recommended she skip chemo based on the gene test, "I would have accepted that", she said. Genes are either off or on. Researchers point out that while the treatment could in principle work for many different kinds of cancer, it will not help everyone.

Patients with a recurrence score of up to ten out of 100 have previously been shown not to benefit from chemotherapy and need only hormone treatment.

Brawley noted that the reduction in chemotherapy might reduce revenues for some oncologists, but he doesn't think they'll care.

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