‘Breakthrough cancer test proves the need for ring-fenced funding’
A LEADING breast cancer specialist has called for ring-fenced funding for more innovative procedures for breast cancer after 12,000 Irish women avoided chemotherapy thanks to a new test.
Professor Janice Walshe, breast cancer oncologist at St Vincent’s Private Hospital in Dublin, has been at the forefront of delivering the Oncotype DX lump analysis test, available through the public system since 2011.
Around 15,000 women have availed of the test created by Exact Science since its introduction here and approximately 12,000 have been given the good news that chemotherapy was not necessary for them.
The others can be confident they are receiving the correct treatment.
Professor Walshe told the Irish Mail on Sunday: ‘These patients have tumours that are hormone sensitive and HER2 negative and we know that, for a long time, we’d been giving chemotherapy to them unnecessarily.’
She said the ‘focus’ in the oncology community at present is to ‘ensure that the Government starts to ring-fence funding for cancer strategy’ that could see more innovations like Oncotype mainstreamed. She told the MoS: ‘We’ve had no allocated money in the last two budgets, so it’s really important that this money starts to be ring-fenced.’
The Trinity and UCD senior lecturer pointed to exciting advances in both ‘technologies that tell us who needs treatment as we move towards a personalised approach’ and ‘better therapeutics to make people do better and not die from this disease’.
‘We need to roll out our screening programmes to make sure that we’re catching these cancers as early as we can.
‘We need to have a focus on prevention because the only way we’re going to take these cancer cases down is by preventing them from happening, as opposed to treating them when they do.
‘And we need to make sure we have the best drugs available to look after them.’
She had used the Oncotype DX test – in which the tumour is removed and sent for analysis – ‘routinely’ in the USA before returning to Ireland in 2006. ‘We had no access, so it was back to the point that you were giving chemotherapy to everybody to try and increase the likelihood that you would benefit the few that would benefit.
‘We were giving about 70% more chemotherapy and people were having all of these side effects for absolutely no benefit whatsoever, so we campaigned strongly to get it,’ she said. Ireland was the only European country in an early trial of the Oncotype DX test.
The results showed that it was ‘the appropriate thing to avoid chemotherapy in a large number of cases’, Prof Walshe said.
‘And on the basis of that we fought for funding.’
In 2011, Ireland became the first European country to offer the test through its public health system (for node negative breast cancer patients – for node positive it has been available since 2020).
‘In 2011 we were in a deep recession and we really urged the Government to say that this was going to be a cost saving manoeuvre,’ said Prof Walshe, who is a key member of Cancer Trials Ireland research group.
‘We knew less chemotherapy would be less toxic for women, less women taking time off work, less childminding.
‘And in addition to that, we’d have less admissions to hospital through side effects related to chemotherapy. So we were ahead of the curve.’
‘And I think with all of the analyses that we have done, there’s no question that it has been a very successful manoeuvre by the Government.
‘And it’s been a huge step forward
‘We need to have a focus on prevention’
for people in terms of avoiding the toxicity of chemotherapy.’
Research led by Professor Walshe showed the use of the test from 2012 to 2022 resulted in net savings to the HSE of over €3m.
Oncotype DX is available to men diagnosed with certain breast cancers too, who number about 30 a year compared to about 3,400 women.
Earlier this week, Professor Walshe described to RTÉ Radio as a ‘significant milestone’ the HSE finally greenlighting the drug abemaciclib which reduces the chances of breast cancer recurrence. The drug was approved by the European Medicines Agency two years ago and available in the UK for over a year.
‘There’s no question it has been successful’