Experimental treatment could be breast cancer breakthrough

Experimental treatment could be breast cancer breakthrough

Henrietta Brewer
June 5, 2018

Globally, the most recent figures are from 2012, when there were 1.7 million new cases and more than half a million deaths.

The results show that all women over 50 with a recurrence score of 0 to 25 can be spared chemotherapy and its toxic side effects.

For the majority of women diagnosed with breast cancer in its early stages, chemotherapy is given for survival and to reduce recurrence of the breast cancer, but a study found that depending on the women's age and risk of getting cancer again, doing chemo doesn't have any benefit.

In a reaction via the Science Media Centre in London, immunotherapy professor Alan Melcher of The Institute of Cancer Research said the trial was "fascinating and exciting".

The study, funded by the National Cancer Institute, foundations and proceeds from the USA breast cancer postage stamp, is the latest development in a national trend on cancer treatments.

New England Journal of Medicine.

Not all breast tumors behave the same way, with a number of different subtypes of breast cancer defined by genetic and protein markers.

After years of follow up, their results were almost identical with women who received hormone therapy yielding a 93.9 per cent survival rate and those with both therapies a 93.8 per cent survival rate. When chemo is used now, it's sometimes for shorter periods or lower doses than it once was.

Over the years, the Cancer Institute has used its $59.8 million in proceeds for studies trying to improve early detection and to determine which cancers are most unsafe and need heaviest treatment and which are less so.

The new study focused on 6,711 women with early stage, hormone receptor-positive, HER2-negative, axillary node-negative breast cancers.

The usual treatment is surgery followed by years of a hormone-blocking drug.

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

During the study, the women were given a genetic test called Oncotype DX to determine their risk for cancer reoccurrence.

The second study tested a form of immunotherapy against chemo, in the most common lung cancer worldwide, known as non-small-cell lung cancer.

Prior to the study, doctors knew women with a low score on the test, less than 11, were told they could skip chemo with no ill effects. Nine-year rates were similar for iDFS (83.3% vs 84.3%), DRFI (94.5% vs 95.0%), RFI (92.2% vs 92.9%), and OS (93.9% vs 93.8%) for the RS 11 to 25 arm.

The study observed a potential chemotherapy benefit in younger women (≤50 years) with an RS of 16-25, while RS 0 to 15 had good prognosis with endocrine therapy.

Oncotype DX is not available in India but samples are sent overseas for the test.

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.

Once a tumor is removed, 21 genes are analyzed and patients receive a low - intermediate - or high risk of reoccurrence.

How does the study fit into the debate over "de-escalating" treatment of early-stage breast cancer?

It shows a woman with an arm raised, in a position meant to portray breast self-examination. The results are sure to accelerate the decline in chemotherapy for the disease.

"The impact is tremendous", study leader, Dr. Joseph Sparano of Montefiore Medical Center in NY, told the Associated Press.

"I was a little relieved. I was planning on dying", she added, "After the treatment dissolved most of my tumours, I was able to go for a 40-mile hike". I also, then, lost my hair. Perkins said she "cornered her with a beer" and said she wanted to enroll. "I'm a firm believer in medical research".

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