Many breast cancer patients can skip chemo, big study finds

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

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

"Until now, we've been able to recommend treatment for women with these cancers at high and low risk of recurrence, but women at intermediate risk have been uncertain about the appropriate strategy to take", study co-author Jeffrey Abrams, associate director of the National Cancer Institute's Cancer Therapy Evaluation Program, which supported the trial, said in the statement.

Hormone-receptor-positive, axillary node-negative disease -- the type of breast cancer studied here - accounts for half of all the breast cancer cases in the USA, and chemotherapy historically has been part of most women's treatment regimen after surgery.

It's a major health headline this morning: a landmark new study finds most women with the most common form of early-stage breast cancer can safely skip chemotherapy.

The TAILORx trial used the Oncotype DX test, which is available on the NHS and which allows doctors to predict the likelihood of the breast cancer returning.

For the TAILORx study, scientists recruited over 10,000 women with the most common type of breast cancer, called oestrogen-receptor positive (ER+) HER2-negative breast cancer. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is created to block the cancer-spurring effects of hormones.

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it. Women with low risk scores - those below 10 - don't need chemotherapy after surgery, and instead can be treated with hormone therapy, previous studies have found.

The two most recent studies it is funding look at tomosynthesis - a newer breast imaging technique - versus standard-of-care 3D mammograms, and research on whether weight loss impacts breast cancer treatment and outcomes. She's very aware that most patients with metastatic breast cancer aren't as fortunate and that experimental approaches can entail big risks.

Past experiments revealed that one group of people particular results of the genetic test would benefit from a combination of endocrine therapy and chemotherapy. The trial results are the latest salvo in a heated debate over when and how to use chemotherapy in combating the spread of the disease. Many women think "if I don't get chemotherapy I'm going to die, and if I get chemo I'm going to be cured", but the results show there's a sliding scale of benefit and sometimes none, he said. In addition, women 50 and younger who scored between zero and 15 could be spared chemotherapy and its toxic side effects.


For many breast cancer patients, one of the most hard treatment decisions is whether or not to go through chemotherapy. Those who score 26 or higher on the scale do benefit and now receive chemotherapy.

A chemo-free treatment isn't for every patient.

By the time the new trial started, the cancer had spread to her liver, as well as lymph nodes in her chest wall and abdomen. "Therefore they should get the chemotherapy along with hormonal treatment".

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.

Litton, the MD Anderson oncologist, said doctors need to consider each case on its own merits and cautioned against ruling out chemo too quickly.

"Chemotherapy is not without its own risks", said Jacoub. The results are sure to accelerate the decline in chemotherapy for the disease.

"The uncertainty is over", she said. Minute amounts of these natural T-cells infiltrate the tumor, though they aren't present in high enough quantities to combat the growing cancer, Rosenberg said.

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