Study finds women with early breast cancer may avoid chemotherapy

Thousands of women with early-stage breast cancer may be able to skip chemotherapy, according to a new study.

The results from the phase 3 TAILORx study were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, and are published in The New England Journal of Medicine.

Texting also played a role in helping patients feel like they were in control of their treatment, particularly during the first month.

The study was funded in part by the proceeds from sales of the breast cancer postage stamp.

Experts believe the case, discussed at the American Society of Clinical Oncology meeting in Chicago, marks the start of a breakthrough for thousands of women who now have no hope.

For the past several years, cancer care has moved away from chemotherapy, with its harsh side effects - including debilitating nausea, hair loss, anemia, fatigue and infection - to gene-targeting therapies, hormone blockers, and immune system treatments. If chemotherapy is used now, it's often used in lower doses and for shorter periods.

Researchers have unveiled a study suggesting that 70 percent of women with HER2-negative breast cancer that hasn't spread to the lymph nodes get no extra benefits from undergoing chemotherapy.

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

Treatment for sufferers may involve radiotherapy or surgery.

Cancer is complex and challenging to study, and news reporting on the disease easily lends itself to hype, contradiction and misinterpretation.

"We're looking forward to a future where cancer is treated using a personalized approach", he added.

Instead of chemo therapy, most women with early stage breast cancer can take a hormone blocking pill with the same results, Figueredo said. Those at high risk are advised to receive it but intermediate was a toss-up until this study. Of the 10,273 women tested, 6,711 (69%) had a score of 11-25.

The test randomized women with intermediate risk, about 67 percent. In both groups 89% of women had survived the disease.

"The new results show that most women over 50, and who score within a given range, will not get any benefit from chemotherapy over and above hormonal therapy", Dr. Dana Abraham said, with Abraham Breast Clinic in Little Rock.

Will people trust the results?

According to first author Joseph Sparano of Montefiore Medical Center in NY, "any woman with early-stage breast cancer 75 or younger should have the test and discuss the results" with her doctor. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint may also be used.

Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston.

Angela Harris, head of Scotland at Breast Cancer Care, said: "This incredible news is game-changing as it means thousands of women in Scotland and across the United Kingdom will be able to avoid chemotherapy with confidence". She hadn't felt any lumps or symptoms and had no family history of breast cancer before the diagnosis, she said.

This work showed "we are now at the cusp of a major revolution in finally realising the elusive goal of being able to target the plethora of mutations in cancer through immunotherapy", he wrote.

  • Joanne Flowers