Many breast cancer patients may safely forgo chemotherapy, findings of a new study called TAILORx have found. Women in early-stage invasive breast cancer with midrange or lower risk for cancer recurrence can skip the treatment.
Side Effects Of Chemotherapy
Chemotherapy helps save lives of cancer patients but it also has side effects, which include hair loss, anemia, nausea and vomiting, and bleeding. It can also have life-threatening complications which include risk of heart failure and leukemia that may develop years after the treatment.
In a new study published in the New England Journal of Medicine on June 3, researchers found that gene tests on tumor samples can identify women who can safely skip chemotherapy.
The genomic test Oncotype DX measures the expression of 21 genes in tumor samples taken during surgery to predict a person's risk for cancer recurrence on a scale of 0 to 100.
The new study found that chemotherapy does not significantly boost survival in patients who scored between 11 and 25, or those in the intermediate risk zone.
Researchers found no significant difference in disease-free survival, later recurrence and overall survival of patients who had hormone therapy alone and those who had hormone therapy plus chemo.
Patients in the intermediate risk zone can do well with hormone therapy alone. They can take a drug that blocks estrogen or stops the body from making the hormone, a treatment called endocrine therapy.
The Oncotype DX test costs $4,600 but Steven Shak, the chief medical officer of Oncotype DX maker Genomic Health, said that it is typically reimbursed by insurance.
Who Can Skip Chemotherapy?
Study researcher Joseph Sparano, from Montefiore Medical Center in New York, and colleagues said that 85 percent of women who are over 50 years old with hormone receptor positive and HER2 negative breast cancer who have a recurrence score of up to 25 can skip chemotherapy.
Forty percent of women younger than 50 with recurrence score between 0 and 15, on the other hand, can skip the treatment.
Sparano said that based on their findings, about 60,000 women in the United States can be spared from getting chemotherapy per year.
Researchers said that the TAILORx study provides the most definite answer on how to treat breast cancer patients based on their Oncotype DX recurrence scores.
"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer," said study researcher Kathy Albain, from Loyola Medicine. "For countless women and their doctors, the days of uncertainty are over."