Women with Common Form of Breast Cancer Can Skip Chemotherapy

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"We can spare thousands and thousands of women from getting toxic treatment that really wouldn't benefit them", Dr. Ingrid A. Mayer, from Vanderbilt University Medical Center and author of the study, was quoted as saying.

"You will see it nationwide and you will see it here", says Sparrow Hospital Oncologist Dr. Gordan Srkalovic. "Patients who had chemotherapy plus an anti- hormone pill versus an anti-hormone pill alone - they had no difference in terms of their survival or outcomes long-term".

Doctors at the U.S. National Cancer Institute concluded that Perkins wouldn't survive with conventional therapy and as a result picked her for a radical new therapy which harnessed the power of her immune system to fight the tumours.

The new approach - a modified version of a technique known as adoptive cell transfer (ACT) - is being developed by researchers at the National Cancer Institute in the USA, and involves sequencing the DNA and RNA of tumours to try to identify mutations that were unique to her specific cancer. And even though Oncotype DX came out in 2004, the experiments that showed chemotherapy helping people with some results of the tests weren't published until 2015.

Over the years, the Cancer Institute has used its $59.8 million in proceeds for studies trying to improve early detection and to determine which cancers are most risky and need heaviest treatment and which are less so.

The study, which used genetic testing and included about 10,000 patients, revealed that women with smaller-sized, estrogen-fueled tumors that had not spread to the lymph nodes fared just as well without chemo as those who received it. Women in the intermediate recurrence score group were randomly assigned to receive either endocrine therapy plus chemotherapy or endocrine therapy alone. Erring on the side of caution, doctors usually give these women chemotherapy.

The trial is due to enrol around 330 patients to fully put the technique through its paces, and should be able to generate statistically-validated results in 2023. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test. Apparently, those who are receiving the said treatment under current medical standards don't actually need it. It showed most patients with an intermediate risk of cancer recurrence can avoid chemotherapy without hurting their chances of beating the disease.

But, researchers say some women 50 and younger in high-risk groups might still need chemo.

"All cancers have mutations, and that's what we're attacking with this immunotherapy", he said.

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The trial focused on HR positive, HER2-negative, node-negative breast cancer, which is the most common type of early stage breast cancer.

Women aged 50 or younger were the notable exception. "I had a tumour in my chest that I could feel shrinking", she said.

This is the largest study ever done on breast cancer treatment.

"Oncologists have been getting much smarter about dialing back treatment so that it doesn't do more harm than good", Steven Katz, a University of MI researcher who examines medical decision-making, told the Washington Post.

Until now, chemotherapy was highly recommended with a result greater than 25, and below 10 it was not.

However, there was unclear evidence on whether those who fall in between - the vast majority of patients - needed chemotherapy.

The team of doctors complemented the cell treatment with "a range of new immunotherapy drugs called "checkpoint inhibitors", Sky News reports, "designed to overcome a cancer's ability to shield itself from the immune system".

Thousands of women have been tested over the years using Oncotype DX to help determine the true effectiveness of chemo.

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