New study says women with early stage breast cancer can avoid chemotherapy

Many breast cancer patients can skip chemo big study finds

Many breast cancer patients can skip chemo big study finds

An experimental therapy that extracts and multiplies powerful immune-system cells from inside tumors eradicated a patient's breast cancer, a scientific first that could lead to new ways of treating malignancies that have resisted all other efforts.

"Oncologists have been getting much smarter about dialing back treatment so that it doesn't do more harm than good", said Steven Katz, a University of MI researcher who examines medical decision-making.

"With results of this ground-breaking study, we now can safely avoid chemotherapy in about 70 per cent of patients who are diagnosed with the most common form of breast cancer", said co-author Kathy Albain, an oncologist at Loyola Medicine.

According to the American Cancer Society, one in eight women will develop breast cancer in her life.

After tumor removal, genetic testing is commonly used to predict which type of chemotherapy would give the most benefit.

"This is a really big deal", said Dr. Adam Brufsky, a coauthor on the new study and a professor of medicine at the University of Pittsburgh.

The treatment, which succeeded after all other conventional treatments had failed, marks the first successful application of T-cell immunotherapy for late-stage breast cancer.

To find the answer, researchers randomly assigned more than 6,700 women with intermediate scores - 11 to 25 - to two groups.

The study is limited in some ways.

Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.


It found that Merck pharmaceutical's drug Keytruda (pembrolizumab) - which famously helped former U.S. president Jimmy Carter stave off advanced melanoma that had spread to his brain - helped lung cancer patients live four to eight months longer than chemo.

Researchers found that more on 83 percent of the women using hormone therapy alone had not developed a recurrence or additional primary cancer.

Past research has shown that women with scores between 0 and 10 could skip chemotherapy, while those with scores over 25 benefited from adding chemotherapy to their hormonal treatment plan.

The study enrolled 10,273 women, of whom 9719 with follow-up data were included in the main analysis set; 6711 women (69%) had an intermediate recurrence score of 11-25, while 1619 (17%) had a low recurrence sore of 10 or less and 1389 (14%) had a recurrence score of 26 or higher.

A woman appears to have been cured of advanced drug-resistant breast cancer after doctors harnessed her own immune system to fight the disease. As welcome as the lack of spread is, it leaves patients and their doctors with a conundrum: Should they undergo chemotherapy, with the often horrendous side-effects that involves, or is surgery and hormone therapy sufficient? She also watched her brother and sister - who died of thyroid cancer and leukemia, respectively - suffer through chemotherapy treatments.

"I don't ever think I'll ever have the feeling that I'm completely out of the woods, but this definitely is exciting and makes me feel good", Mall said.

The study was funded by the National Cancer Institute, some foundations and proceeds from the USA breast cancer postage stamp.

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

"Chemotherapy is no Shangri-La", Brawley said.

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