According to a large clinical trial. Many oncologists are saying this may be a game changer in the treatment of breast cancer. I sure hope so!
https://www.forbes.com/sites/elaineschattner/2018/06/03/many-breast-cancer-patients-can-safely-skip-...
A large study confirms that many patients with early-stage breast cancer don’t need chemotherapy after surgery. The TAILORx trial evaluated a pathology test called OncotypeDx (Genomics Health), which predicts risk of recurrence, and found the test to be reliable.
The TAILORx trial involves over 10,000 women with the most common form of breast cancer. All had hormone receptor (HR) positive (+), Her2 negative disease, with tumors not involving lymph nodes. All had Oncotype testing of their tumors. Now with 8 years of follow-up, the main finding is that for patients with low or intermediate Oncotype results, taking chemotherapy in addition to hormone-blocking endocrine treatment does not affect survival or lower the likelihood of cancer’s recurrence.
As a former practicing oncologist and survivor of early-stage breast cancer, I think the TAILORx findings are among the most important reported since I entered the field. These results have the potential to reduce overtreatment of breast cancer—stopping patients’ unnecessary exposure to chemotherapy—in a large fraction of cases.
Today in Chicago, Dr. Joseph Sparano is presenting the TAILORx findings in a plenary session at the annual meeting of the American Society of Clinical Oncology (of which I am a member). Sparano is a professor at the Albert Einstein School of Medicine in New York. The full paper is now published in the New England Journal of Medicine.
According to the NCI, in 2018 over 260,000 Americans will receive a new diagnosis of invasive breast cancer. Around half of all U.S. breast cancers are hormone sensitive and axillary lymph node negative; the study cites these published NCI data on the prevalence of breast cancer subtypes. “Our study shows that chemotherapy may be avoided in about 70% of these women when its use is guided by the test,” Sparano said in a press statement.
According to Dr. Steven Shak, an oncologist, co-founder and chief medical officer of Genomics Health, only around 1 in 6 Oncotype scores indicate a high risk of recurrence. Approximately two thirds of all Oncotype results fall in intermediate range (11 – 25); the other third splits almost evenly between low-risk (0 – 10) and high-risk (26 - 100) of recurrence. I spoke with Shak by phone about the TAILORx trial and its implications.
The takeaway is that most patients with lymph node-negative, hormone-sensitive, Her2 negative breast cancer don’t benefit from chemo, Shak told me. “I see this as part of the end of an era,” he said. “In the past, the majority of women with breast cancer got chemotherapy, and now it’s only the minority who need chemotherapy.” The public health implications are huge, he continued: “If we give chemotherapy only to early-stage patients at high risk, we can avoid overtreating and exposing many women to chemotherapy who don’t need it.”
I haven't posted the entire article since it is relatively long.
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