Breast patients can be spared chemotherapy

Up to 5,000 British women a year could safely avoid gruelling drug therapy, study finds

Thousands of breast cancer patients could safely be spared “gruelling” courses of chemotherapy, according to a trial. A long-term study of women with the most common form of the disease found less than a third should be put on the drugs. The New York trial found that for a significant proportion of the patients diagnosed at an early stage, their survival chances were just as good if they took only oral hormone medication, which comes with far fewer risks and side effects.

THOUSANDS of breast cancer patients currently prescribed chemotherapy can safely avoid the “gruelling” treatment, according to a trial hailed as the biggest advance in cancer practice for 20 years. A long-term study of women with the most common form of the disease found less than a third should be put on the drugs, rather than the more typical ratio of 50 per cent.

The trial found that for a significant proportion of the patients diagnosed at an early stage, their survival chances were just as good if they took only oral hormone medication, which comes with far fewer risks and side effects.

The results have been welcomed as “fantastic news” by cancer charities, while leading oncologists said they should “transform care immediately”.

Dr Alistair Ring, a consultant in medical oncology at The Royal Marsden hospital in London, said last night: “On Monday in the clinic, I will offer less chemotherapy that will not be of benefit to patients, and that is very reassuring.”

Scientists at the Montefiore Medical Centre in New York studied more than 10,200 women with hormone receptor-positive, Her2-negative, axillary node-negative breast cancer, a type that affects around 23,000 British women a year.

Biopsies were taken and subjected to the Oncotype DX genetic test, available on the NHS, which gives patients a risk score of the disease returning after surgery, based on examining 21 genes. The women then received either chemotherapy with hormone drugs, or hormone drugs alone.

After a nine-year follow-up, the researchers noted that patients who had been given an “intermediate” risk score had an almost identical chance of surviving – 93 per cent – regardless of which regimens they were on.

Under current NHS practice, many women with this score are put on chemotherapy. Experts calculate that, thanks to the results of the TAILORX trial, up to 5,000 British patients a year can now be spared the treatment.

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “It’s fantastic news that this landmark study could now enable thousands more breast cancer patients over 50 to be safely spared gruelling chemotherapy.

“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.” Breast cancer survival has roughly doubled in the UK over the past four decades, with chemotherapy a “cornerstone” of treatment.

The side effects can be notoriously severe, with a higher long-term risk of developing heart failure and even leukaemia.

However, Dr Ring said that better understanding of the risk scores provided by gene assay tests such as Oncotype DX marked a “step-change” in the targeted use of chemotherapy.

Dr Harold Burstein, a leading Asco oncologist, said the new data had the capacity to “transform care immediately, and for the better”.