Breast cancer gene breakthrough set to spare thousands from chemotherapy

‘Far fewer side-effects’ ‘Major step forward’

A REVOLUTION in breast cancer treatment will spare thousands of women from the ordeal of chemotherapy, British scientists believe.

They are carrying out a landmark trial which involves patients undergoing a genetic test shortly after being diagnosed with cancer.

This determines how aggressive the cancer is, whether chemotherapy is needed and if tumours are even likely to respond to the debilitating treatment.

Researchers from University College London, who are behind the trial, say that the test could allow up to 5,200 patients to avoid chemotherapy each year.

Chemotherapy is the mainstay of cancer treatment and it is given to approximately 16,000 breast cancer patients in England every year.

But it causes crippling side- effects including exhaustion, infections, sickness and hair loss, which are usually far worse than symptoms of cancer itself.

Many patients say they never fully recover and it can lead to heart damage, leukaemia – a type of blood cancer – and in some cases, death.

Yet researchers believe that the majority of patients don’t benefit from chemotherapy and would be just as well taking daily oestrogen-reducing tablets, which have far fewer side-effects.

The trial, which was launched in January, is funded by the NHS and is overseen by scientists at UCL, Cambridge University and Warwick University’s Clinical Trials Unit. It involves 4,500 patients.

Called Optima, it is the first of its kind to measure how well chemotherapy will work for a patient – or ‘chemotherapy sensi- tivity’. The early findings will be presented next week at the National Cancer Research Institute’s Conference, the UK’s largest cancer conference.

The test, called Prosigna, is carried out by a machine which measures the activity of 50 genes taken from a small sample of a breast cancer tumour.

Each patient is given a score out of 100 based on how aggressive their cancer is and whether chemotherapy would prove effective.

Chemotherapy works by killing fast-growing cells so, in theory, is only worthwhile in patients with aggressive, fast-growing cancers.

The trial will run for six years, during which time researchers will compare the survival rates of patients treated with chemother- apy with those only given tablets. If the test is found to be safe and cost effective – as the researchers expect – it will be rolled out across the NHS.

They also calculate it would save the health service £17million a year from not administering chemotherapy, which costs an average of £4,000 a course.

While the trial is underway, the scientists are hoping to make the test even more accurate so it can enable more women to avoid chemotherapy.

Professor Rob Stein, lead researcher from University College London, said it was the ‘first step’ in an entirely new approach to treating breast cancer.

‘If we can put chemotherapy behind us, and discard it for those people that it’s just not going to help, then we can move on to things that will help.’

‘We can reduce chemotherapy very substantially in that group of women.’

Around one in eight women develop breast cancer during their lifetime. There are just over 55,000 new cases a year in the UK and around 11,400 deaths.

Approximately a third of women diagnosed with breast cancer in any given year will have chemotherapy that same year.

There are currently 65 hospitals involved in the trial and recruiting patients but researchers want another 40 to join.

Patients will initially have surgery to remove the cancer, and radiotherapy to get rid of any remaining cells after which a sample of tumour will be tested.

Depending on their score, they will either be offered chemotherapy followed by daily tablets to reduce oestrogen or tablets alone.

Dr Richard Berks, of the charity Breast Cancer Now, said the test would be a ‘major step forward’.

He added: ‘This important trial will demonstrate whether this promising test can help identify which patients will benefit from chemotherapy, and those who won’t and can avoid its difficult side-effects.’