Many Breast Cancer Patients Can Skip Chemo, Big Study Finds


A promising experimental treatment has left a Florida woman's advanced breast cancer in remission. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Earlier research found that a patient with a high-risk case, or score of 26-100, would benefit from chemotherapy, while a patient at the lower end with a score of 10 and under would not. Or was it sufficient for them to be treated only with endocrine therapy, which blocks the cancer-spurring properties of hormones?

"The study should have a huge impact on doctors and patients", said Dr Kathy Albain, one of the main co-authors. "Patients who had chemotherapy plus an anti- hormone pill versus an anti-hormone pill alone - they had no difference in terms of their survival or outcomes long-term".

Bachini's initial surgery removed two-thirds of her liver, but three months later the disease showed up in her lungs.

"It feels miraculous, and I am beyond amazed that I have now been free of cancer for two years", Ms Perkins said.

"You will see it nationwide and you will see it here", says Sparrow Hospital Oncologist Dr. Gordan Srkalovic. "If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers".

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In this case study, they identified 62 mutations, and then tested samples of Perkins' tumour-infiltrating lymphocytes (TILs) - a form of white blood cell primed to identify and destroy mutated cells - to find those that were particularly active against cells with one or more mutations. Similar tests including one called MammaPrint may also be used. Similarly, women with high risk scores - above 25 - should receive chemotherapy in addition to hormone therapy. It was the women in the intermediate stages of 11-25 who oncologists often had differing views when prescribing standards of care.

In this latest study, researchers focused on the 69 percent of the clinical trial's participants who had mid-range test scores. To conduct the study, women in the intermediate groups were either prescribed chemotherapy or given treatment absent of the use of chemotherapy. Under 50s with a score of up to 15 can also be spared the treatment, according to the research.

This was particularly true for women between the ages of 50 and 75.

The researchers were specifically interested in women who scored 10 to 25 on the test - scores that fall in the range of a medium risk of the cancer returning after surgery. But of the 7,000 women overall in the 11-25 range, 70% wouldn't have actually needed chemotherapy, Kathy Albain, an oncologist at Loyola University Medical Center in IL, told NPR.

If doctors adopt the study's findings, a lot of women could be affected.

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All told, about 70 percent of women with this particular cancer - meaning more than 85,000 women a year in the United States - can safely forgo chemotherapy, the experts concluded.

Forty-nine-year-old Judy Perkins was faced with a terrifying prognosis after several rounds of punishing chemotherapy had failed to stop a tumour in her right breast.

About 41,000 women and 465 men died from the disease that year.

The study was centered on a 21-gene test performed on tumors that has been available for breast cancer patients since the early 2000s. No less daunting than the diagnosis itself was the prospect of chemotherapy and its associated side-effects - hair loss, nausea, etc.

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