New study: 70% of early stage breast cancer patients don’t need chemotherapy

4 June 2018

New study: 70% of early stage breast cancer patients don’t need chemotherapy

A recent study published in the New England Journal of Medicine has found that most women in the early stages of breast cancer can safely skip chemotherapy without risking the chances of a full recovery.

The findings showed that 70% of women who are diagnosed with the common cancer that has not spread to the lymph nodes could avoid chemotherapy entirely without increased risks of recurrence and ability to be cured, said Loyola Medicine oncologist, Dr Kathy Albain, a co-author of the study and a member of the clinical trials steering committee.

“The study should have a huge impact on doctors and patients,” Dr Albain said. “We knew we were overtreating a lot of women with chemotherapy, in our gut. We can de-escalate toxic treatments and do that with certainty.”

The study and its findings, which have been followed by oncologists since its start in 2006, has been praised by cancer research advocates as substantial progress made possible by cutting-edge advances in genomics.

“I don’t get optimistic about a lot of things, but I’ve been very optimistic about this,” said Otis Brawley, chief medical officer of the American Cancer Society.

Mr Brawley said that aside from offering patients and doctors peace of mind about forgoing chemotherapy, the results of the study can now ensure that patients do not have to endure the harsh effects and risks of the therapy which includes hair loss, debilitating nausea, vomiting, and being at increased risk of leukaemia and congestive heart failure.

“Chemotherapy is no Shangri-La,” Brawley said. “We’re saving people these side effects.”

The study enrolled 10,273 women who had the most common type of breast cancer (hormone-receptor positive, HER2 negative) that had not spread to the lymph nodes.

The patients were randomly assigned hormone therapy or chemotherapy, followed by hormone therapy.

The study was centred on a 21-gene test performed on tumours that has been available for breast cancer patients since the early 2000s.

The test examines genes from a patient’s breast cancer biopsy sample and allows doctors to assign a patient a “recurrence score” from 0 to 100, according to a press release from Loyola Medicine.

The study found that for participants with gene test scores between 11 and 25 (especially among women ages 50 to 75) there was no significant difference between the chemotherapy and non-chemotherapy groups.

Among women younger than 50, outcomes were similar when gene test scores were 15 or lower, and younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group, the study found.