Friday 18 October 2019

Thousands of breast cancer patients could avoid chemotherapy, ground-breaking study finds

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Stock photo

Thousands of breast cancer patients may be safely spared gruelling chemotherapy following a landmark study.

The  TAILORx trial found that chemotherapy can be avoided for 70 per cent of women with the most common type of early stage breast cancer (HR-positive, HER2-negative, node-negative breast cancer).

10,273 women with early-stage breast cancer from Ireland, the US, Australia, Canada, New Zealand and Peru took part in the trial.

690 women from Ireland participated, led by Professor Maccon Keane, Consultant Medical Oncologist, University Hospital Galway, as the Chief Investigator.

Charity Breast Cancer Care said it was a "life-changing breakthrough".

The Chief Investigator for Ireland, Professor Keane, said: “The TAILORx trial result is a major advance in precision medicine for women with hormone receptor positive node negative breast cancer.

“It confirms that using the 21-gene expression test on tumours we can identify which women will benefit from endocrine (hormone) therapy only, thus eliminating the need for them to have chemotherapy.

“It also helps identify those women with this disease who really do benefit from the chemotherapy they receive.

“Having the trial in Ireland has enabled more personalised treatment recommendations for women with this stage and type of breast cancer as we have had access to the test through the HSE since 2011.

“Irish women contributed significantly to this trial and can be rightly proud of their input into improving care for future women who present with breast cancer.”

Commenting on the results, Professor Bryan Hennessy, Clinical Lead, Cancer Trials Ireland, said this could be critical for how breast cancer patients are treated.

“This is a globally important breast cancer trial. These results will inform clinical decision-making and in future many women with certain types of early-stage breast cancer can avoid chemotherapy, without impacting on the success of their treatment.

“We are delighted that with the support of these patients, our research teams, under the umbrella of Cancer Trials Ireland, were able to play a leading role in this research”, he said.

The TAILORx trial used the Oncotype DX test, which allows doctors to predict the likelihood of the breast cancer returning.

A sample of the 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 10 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.

However, there was unclear evidence on whether those who fall in between - the vast majority of 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 and only receive hormone therapy drugs after surgery, according to the research.

Nine-year survival rates were 93.9pc without chemotherapy and 93.8pc with chemotherapy, the study found.

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