BREAKTHROUGH TO SLASH BREAST CANCER CHEMO
The therapy isn’t needed for many women who have had surgery for early-stage breast cancer, say researchers
250 women here could be spared
HUNDREDS of Irish breast cancer patients may be spared gruelling chemotherapy following a landmark study.
An international trial of more than 10,000 women with the most common form of early breast cancer found the drug treatment was unnecessary for many after surgery.
The findings will lead to a ‘fundamental change’ in how the disease is treated, a leading oncologist said, with an estimated 250 Irish women likely to avoid chemotherapy every year as a result of the research into the most common form of breast cancer, known as hormone-receptor positive, HER2-negative, node-negative.
Most patients receive chemotherapy after surgery to remove their tumour. This is to prevent recurrence of the disease.
However, the results of the Tailorx trial show that only 30% of women with this particular form of early-stage breast cancer benefit from the treatment.
Ireland had the highest participation rates of the Tailorx trial in the world, with an estimated 30% of women here with early breast cancer included, according to Cancer Trials Ireland, a not-forprofit organisation.
Dr Maccon Keane, a consultant medical oncologist at Galway University Hospital, was principal Irish investigator on the Tailorx trial, which examined the effect of genes on cancer rates.
The comprehensive study, presented at the American Society of Clinical Oncology annual meeting in Chicago, is thought to be the largest breast cancer treatment trial ever conducted.
Dr Alistair Ring, consultant oncologist at the Royal Marsden NHS Hospital in London, said: ‘This... will lead to a considerable number of women no longer needing to have chemotherapy.’
The Tailorx trial used the Oncotype DX test, which is funded by the HSE for public patients referred by their oncologist. Private patients with Aviva Health, VHI and Laya Healthcare are also covered for the cost.
A sample of the cancer tumour is tested after surgery for 21 genetic markers, which indicate if it could grow and spread.
Patients with a recurrence score of up to ten out of 100 have previously been shown not to benefit from chemotherapy, and instead need only hormone treatment.
Those who score 26 or higher on the scale do benefit and currently receive chemotherapy.
But there was unclear evidence on whether those who fall in between – most patients – needed chemotherapy. The Tailorx study, led by the Montefiore Medical Centre in New York, found women older than 50 with this form of breast cancer and a score of up to 25 did not need chemotherapy.
Under-50s with a score of up to 15 can also be spared the treatment, the research suggests.
Dr Ring said the study would represent a significant shake-up in the treatment of early-stage breast cancer. ‘It is a significant step because it is about avoiding a treatment that, for most people diagnosed with cancer, is what they all fear being suggested to have,’ he said.
‘I, as an oncologist on Monday in clinic, will offer less chemotherapy that will not be of benefit to patients and that is very reassuring to know that when I am offering patients chemotherapy they are likely to benefit from it.’
The study of 10,273 women, led by Dr Joseph Sparano at the Montefiore centre, is in the New England Journal of Medicine.
The findings come as the HSE’s BreastCheck service is under major scrutiny due to missed cancer cases.