January 23, 2019

New study finds many women with early-stage cancer could skip chemotherapy

08 June 2018, 12:18 | Randall Craig

Many Breast Cancer Patients May Not Need Chemotherapy

In a rare triumph for tough-to-beat pancreatic cancer patients who had surgery lived substantially longer on a four-drug combo than on a standard cancer drug according to research released on Monday

The study, released this weekend, finds women with the most commonly diagnosed form of breast cancer may not have to undergo chemotherapy.

"Breast cancer is the most common cancer in women in the United States and worldwide", note the study authors.

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

"It does tend to cause significant side effects such as fatigue and hair loss issues that really do trouble women", said Moore.

"Chemotherapy is not without its side effects, but it's still a discussion that a woman has to have with her physician", said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital.

The analysis was financed by the National Cancer Institute, a few Some research leaders consult with breast cancer drugmakers or to the business which produces the gene evaluation.

Countless breast cancer patients in the future will be spared millions of dollars of chemotherapy thanks in part to something that millions of Americans did that cost them just pennies: bought a postage stamp. When chemo is used now, it's sometimes for shorter periods or lower doses than it once was.

According to Dr. Schmidt, "By looking at different genes in the breast cancer, the oncotype test can predict if women are low risk, intermediate risk, or high risk or recurrence and what their benefit or lack thereof of chemotherapy might be". Doctors know that most don't need it, but evidence is thin on who can forgo it.

When patients enrolled in the trial, their tumors were analyzed using the 21-gene expression test and assigned a risk score (on a scale of 0-100) for cancer recurrence.

The new results are on the 67 percent of women at intermediate risk.

Around half of women taking aromatase inhibitors, a common drug for postmenopausal women with hormone receptor positive breast cancer, experience joint pain.

After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.

"We still need to be very cautious in our young patient population with breast cancer, anyone under the age of 50. And this is the promise of personalized medicine, and it's arrived", Agus said.

"We believe that this may be a practice-changing trial", said Dr. Geertjan Van Tienhoven, from the Department of Radiation Oncology, Academic Medical Center in Amsterdam. Similar evaluations like one called MammaPrint are also widely used.

Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston.

The study was extensive so patients who fit in this new category should be very confident with their course of treatment, even if it's without chemotherapy.

There is one caveat to the new findings. She said hearing about the new study is thrilling.

"I was a little relieved". She said, "I was in the grey area". The treatments "weren't pleasant", she concedes.

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