A team of researchers says it has opened up a chance for millions of breast cancer patients to avoid chemotherapy. They claim to have developed a DNA test that can tell which patients chemotherapy will work for and which it will not. The research, led by University College London (UCL) in England, was reported by the BBC.
The study involved more than 4,000 patients diagnosed with breast cancer, including patients aged over 40 from the United Kingdom, Norway, Sweden, Australia, New Zealand and Thailand.
The international study found that more than two-thirds of participants could be treated with hormone therapy alone, avoiding chemotherapy. Chemotherapy can commonly cause complications such as fatigue, nausea, hair loss, fertility problems and a weakened immune system.
The researchers named the test “Prosigna.” It analyses the activity of 50 genes that mainly influence how cancer spreads, essentially calculating how likely the disease is to return.
Those with low scores did not have chemotherapy — two-thirds of the 4,000. The five-year survival rate in this group was 93.7 percent, compared with 94.9 percent among patients who had chemotherapy.
As an initial treatment for breast cancer, the tumour is usually removed by surgery, after which doctors recommend chemotherapy to reduce the risk of cancer cells returning. Even patients at an early stage, where cancer cells have spread only around the lymph nodes, are given chemotherapy. UCL said doctors had raised a concern: that for many breast cancer patients, chemotherapy is of little benefit. According to the university’s estimate, more than 5,000 patients under the UK’s National Health Service (NHS) now have the chance to avoid it.
Karen Bonham, a Cardiff resident, took part in the study and said the result was “a great relief” — much like receiving “a Christmas present.” The Prosigna test allowed the 64-year-old to avoid chemotherapy; she has had radiotherapy and hormone therapy over the past eight years. “Being diagnosed with cancer and starting its treatment are both life-shaking events,” she said. “It pushes you into a world of uncertainty. The list of life’s priorities changes; there is just one wish left, and that is to survive.”
The results were to be presented at the annual meeting of the American Society of Clinical Oncology — the world’s largest cancer conference — in Chicago. The head of the study, Professor Rob Stein, a breast cancer specialist at the UCL Cancer Institute, said the results could be seen as an important step in tailoring cancer treatment to the individual, as the study relied not only on conventional clinical features but also on the tumour’s biological characteristics. For patients, he said, it means many could be freed from the physical and mental strain of chemotherapy and its side effects, while for the health system it would ensure a more appropriate, evidence-based use of resources. UCL said it had not yet been tested whether the same results apply to patients under 40, and that final results on this could take several more years.
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