No chemo? Triangle doctors excited by new findings for breast cancer patients

Pancreatic cancer patients could live more than twice as long if given chemotherapy and radiation treatment before surgery

New findings from the groundbreaking Trial Assigning Individualized Options for Treatment (Rx), or TAILORx trial, show no benefit from chemotherapy for 70 percent of women with the most common type of breast cancer. "We originally, years ago, just did surgery, and then for many many years, everybody got chemotherapy, and now we know that we have these anti-hormonal drugs and pills that women can take". Good news though - a brand-new study that has just come out says that patients who are diagnosed with early-stage breast cancer with smaller-sized tumors that has not spread to the lymph nodes may be able to skip the chemo. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.

By continuing the personalized assessment of an individual's cancer recurrence risk, oncologists can more effectively determine specifically-tailored treatments based on that patient's genomic results.

The scientists carried out a prospective trial, sponsored by the National Cancer Institute, involving around 10,000 women aged 18-75 years with hormone receptor-positive, human epidermal growth factor receptor 2-negative, axillary node-negative breast cancer, which accounts for approximately half of all breast cancers.

"The results of PREOPANC trial certainly strengthens the argument for it", said Chang.

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In the study, women were deemed to have a medium level risk of the cancer recurrence based on a 21-gene panel known as Oncotype DX. Lastly, these cancer diagnoses must land between 11 and 25 on the Oncotype DX Breast Recurrence Score test. None of these differences were considered statistically significant. Now research on more than 10,000 patients finds those mid-range women can safely be spared chemotherapy without affecting survival rates. This confirms similar findings from earlier studies.

Those who score high - 26-100 - receive both hormone therapy and chemotherapy. More studies are still needed to look at those groups of women.

The new results demonstrate that chemotherapy is not beneficial for most women in the intermediate-risk group. To conduct the study, women in the intermediate groups were either prescribed chemotherapy or given treatment absent of the use of chemotherapy.

"This study is an example of how treatments can be refined in an attempt to work better for patients", said ASCO expert Dr. Andrew Epstein. Women deemed at intermediate risk may be considered for it, but on a patient-to-patient basis. However, it is unclear if this benefit is due to the effect of chemotherapy or to endocrine suppression caused by chemotherapy-induced menopause.

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