Chemo 'unnecessary' for thousands with breast cancer


First, this is a study of just one form of breast cancer and the authors found that chemo could still benefit some patients with the cancer - mainly younger women, regardless of their tumor's genetic "score".

The study, led by the Albert Einstein Cancer Center in NY, is a rare cancer breakthrough as it can save money and instantly change practice. Previous studies had made clear that women with low scores could skip chemotherapy and those with high scores should get it.

Albain said research is ongoing, as scientists are now exploring questions about what types of chemotherapy might be effective on various groups based on their genomics, and what will happen to the participants of the clinical trial as even more time passes.

Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, successfully confirmed the benefit of endocrine therapy (ET) alone in patients with early-stage breast cancer who have an Oncotype DX Breast Recurrence Score (RS) of 11 to 25.

"Part of the excitement is because all cancers contain mutations, it's a technique that could potentially be applied to any tumor type", Rosenberg said. "In the current study, we found that the tumors of African-American women attract regulatory T-cells that calm down our killer lymphocytes and inhibit the body's ability to defend against cancer". These womenrandomly divided into two groups: One group received only hormone therapy after surgery, and the other group received both hormone therapy and chemotherapy.

It's one of a few branded tests that have been developed for this objective and is recommended for use in the United Kingdom by the National Institute for Health and Care Excellent (NICE).

Immunotherapy trains a patient's own immune cells to recognise and fight cancer.

The study published on Sunday, on which early-stage breast cancer patients can forgo chemo, is by far the most impactful so far. Sparano concluded that in women with HR-positive, HER2-negative, AN-negative breast cancer who had a RS of 11 to 25, adjuvant ET was not inferior to CET in the ITT analysis.

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

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As always, more research will clarify these findings, but for now, this new information will likely save thousands of women the pain and long-term health toll of chemo, while not at all affecting their chances of beating cancer.

James Doroshow, director of the division of cancer treatment and diagnosis at the National Cancer Institute, which was the primary sponsor of the study, predicted that the trial would lead to changes in treatment "for a large number of potential patients".

While the new study fills in a crucial gap of medical knowledge, what remains confusing is what took so long to get the point where we can measure twice and cut once, so to speak.

In some cases, the results will go on to change how patients are treated.

'Now with these genomic tests, we are finding that we have multiple types of breast cancer, perhaps several dozen and we are being able to tailor our therapies to the type of breast cancer every woman has, ' Brawley added.

The researchers are "trying to find ways" to achieve more consistent outcomes, Goff said.

Very high scores are at increased risk of the cancer spreading, and those patients have benefited a lot by chemotherapy.

Harold Burstein, a breast cancer specialist at Dana-Farber Cancer Institute, said that in some ways the debate over de-escalation misses a larger issue. The researchers gave half the women hormone-blocking drugs alone, and half hormone-blocking drugs and chemotherapy.

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