Breakthrough breast cancer study means fewer women needing chemotherapy

For some breast cancer patients, the chemo decision may now be easier

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.

The treatment involves a highly personalized approach and a patient's tumor is genetically analyzed to "identify the rare changes that might make the cancer visible to the immune system".

The breast cancer epicemic can not be reversed without considering women's exposure to chemical cocktails throughout their lives, argued Professor Andreas Kortenkamp of the University of London, presenting new scientific evidence to the European Parliament.

The study is thought to be the largest breast cancer treatment trial ever conducted.

"It feels miraculous, and I am beyond amazed that I have now been free of cancer for two years", Perkins said.

The findings were published in the New England Journal of Medicine.

Rachel Rawson, of Breast Cancer Care, added: "This life-changing breakthrough is absolutely wonderful news and could liberate thousands of women from the agony of chemotherapy". The results suggest that nearly 70 per cent breast cancer patients can avoid chemotherapy.

The study cast doubt on chemo's necessity in treating women in the early stages of the disease if: 1) there is no spread to lymph nodes; 2) the cancer is hormone-positive; and 3) the cancer is not the type targeted by the drug Herceptin.

All of the women in the study, called the Trial Assigning Individualized Options for Treatment (Rx), or TAILORx, had their breast tumors analyzed with a molecular test. They found that there was nearly no difference in the cancer-recurrence rates between the women who received just hormone therapy and the women who received both treatments. Most women who fit this criteria need only surgery and hormone therapy, he said. "I spoke to four people about her case, including one of the doctors associated with the Tailorx trial", said Dr Ramesh Sarin, senior consultant surgical oncology at the Indraprastha Apollo Hospitals.

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"We have to develop a new drug for every patient", Rosenberg said.

It is the first time that a patient with late-stage breast cancer has been successfully treated by a form of immunotherapy that uses the patient's own immune cells to find and destroy cancer cells that have formed in the body.

Once a tumor is removed, 21 genes are analyzed and patients receive a low - intermediate - or high risk of reoccurrence. A score lower than 10 means the risk of distant recurrence is low, and the women will not benefit from chemotherapy.

The team reports the case of a Florida woman named Judy Perkins, who was diagnosed in 2003 with breast cancer when she was still in her 30s.

Professor Arnie Purushotham, senior clinical advisor at Cancer Research UK, said that by grouping patients based on how likely their cancer is to return, the trial shows great potential to ensure treatment is kinder without compromising its effectiveness. Chemotherapy did benefit women younger than 50 who had a RS between 15 to 25.

For many breast cancer patients, one of the most hard treatment decisions is whether or not to go through chemotherapy. We owe those who took part in this trial our thanks.

"They were able to give the patient's own immune system a major boost".

Carey pointed to some "grey areas" at the boundaries of the recurrance scores that need futher investigation, and said patients would need to discuss these details with their doctors before any decisions on treatement are made.

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