Published: Thu, June 07, 2018
Medicine | By Tracy Klein

Hormone therapy will replace chemotherapy for most breast cancer treatment

Hormone therapy will replace chemotherapy for most breast cancer treatment

SUNDAY, June 3, 2018 (HealthDay News) - A majority of women with an early form of a common breast cancer may be able to skip chemotherapy, depending on the results of a comprehensive gene test. The results are sure to accelerate the decline in chemotherapy for the disease.

Hormone-receptor-positive, axillary node-negative disease accounts for approximately half of all cases of breast cancer in the US, and the National Institutes of Health has previously recommended adjuvant chemotherapy for most patients, the authors write.

The subset of breast tumours that form the focus of this study are driven by hormones (oestrogen), do not respond to drugs such as trastuzumab (also known as Herceptin - an engineered antibody that targets HER2), and haven't yet spread to the lymph nodes.

For many patients, it's a hard choice to decide whether to go through chemotherapy. After two years, she still remains cancer-free.

"This is another significant step towards personalised breast cancer treatment and we hope these practice-changing findings will now help refine our use of chemotherapy on the NHS", she said. The cells go on to attack all the tumours and shrink them in size finally curing the 49 year old woman. Now they can have confidence in those decisions, experts said. The treatment succeeded after all other conventional approaches failed.

Usually, after the removal of the tumor, many women undergo chemotherapy combined with hormonal treatment to prevent any return of the cancer.

According to the Irish arm's lead investigator, Prof Maccon Keane of University Hospital Galway, this trial result "is a major advance in precision medicine for women with hormone receptor positive node negative breast cancer".

Breast cancer is the most common cancer in women worldwide; the World Cancer Research Fund International reported 1.7 million new cases in 2012.

Using a 21-gene expression test, the trial identified 70% of women with a low risk of cancer recurrence after surgery who could avoid chemotherapy.

However, certain women 50 or younger will still benefit from having chemotherapy.

For women under 50 with a score of 0 to 15, chemo could be skipped.

The new study of almost 7,000 women found that use of the already available Oncotype DX gene test could pinpoint those women who needed chemotherapy, and those who did not. "Its findings will greatly expand the number of patients who can forgo chemotherapy without compromising their outcomes". She had a lumpectomy, followed by a mastectomy, and had a recurrence score of 12 or 13, which put her in the middle range.

Believing she had less than three months to live, she had left her job as a structural engineer and was working her way through a "bucket list" of activities to complete before she died. She got only tamoxifen. For those people, the side effects of chemotherapy could have been avoided, without making the treatment any less effective.

Dr Ring said the publication of the trial results was "timely", adding: "I would be very, very keen that the TAILORx results are incorporated into that evaluation".

Laccetti's cancer has not returned. "We're catching it earlier, earlier stages...it's no longer a death sentence".

The overall survival rate was similar: 93.9% for those who received hormone therapy alone and 93.8% for those who received both therapies.

That could affect up to 70,000 women a year in the United States of America and thousands more around the world, the study said.

But as the AP points out, in recent years, cancer treatment has been evolving and moving away from chemotherapy.

The CRCWM is among a few dozen groups that helped conduct research and find local patients for the groundbreaking study.

The technique has previously been used to treat blood cancers and melanoma, but "it is the first time the treatment has been successful for late-stage breast cancer".

Charity Breast Cancer Care said it was a "life-changing breakthrough".

"The treatment sometimes makes you sicker than the disease", Tuttle said. We owe those who took part in this trial our thanks.

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