Which breast-cancer patients will benefit from chemotherapy?
Posted: November 13, 2018 | Word Count: 608
New results from the largest ever clinical study of early-stage breast cancer patients are changing the game when it comes to who should receive chemotherapy treatment.
The study, called TAILORx (Trial Assigning Individualized Options for Treatment (Rx)), used the Oncotype DX Breast Recurrence Score® genomic test to determine exactly who will benefit from treatment with chemotherapy. Approximately 260,000 women are diagnosed with early-stage breast cancer each year in the U.S., and each of them must decide if chemotherapy is necessary to treat their disease or if they can be effectively treated with hormone therapy alone.
Published in The New England Journal of Medicine, the groundbreaking study clearly identified that 70 percent of women with early-stage breast cancer receive no benefit from chemotherapy and the minority of women for whom chemotherapy can be life-saving.
Dr. Ray Lin, co-director of the Breast Cancer Program at Scripps MD Anderson Cancer Center in San Diego and one of the principal investigators of the study, has been using the test to inform personalized treatment recommendations for breast cancer patients at his medical practice for several years. “The recent results, which studied more than 10,000 women, are changing the way that doctors around the world treat the disease by making regular use of the Oncotype DX test in breast cancer diagnosis and individualized treatment,” said Lin. With this new information, doctors can now provide patients with a clear yes or no recommendation about undergoing chemotherapy based on their genomic test score.
Used for early-stage breast cancer patients, the test assesses the level of activity of 21 cancer-related genes generating a Recurrence Score result — a number between 0 and 100.
A Recurrence Score result in the range of 0-25 means that cancer is less likely to come back if treated with hormonal therapy alone and that chemotherapy will not change the clinical outcomes in most patients over hormonal treatment. A Recurrence Score result in the range 26-100 suggests a greater risk that cancer will come back, and that chemotherapy is very likely to provide substantial benefit in reducing this risk in addition to hormone therapy.
At age 42, Angela was diagnosed with breast cancer after her annual mammogram. Following a mastectomy, her doctor recommended hormonal therapy and chemotherapy. She was hesitant to pursue chemotherapy after learning about its immediate side effects and potential long-term effects. As a mother of four, she was worried that chemo would inhibit her ability to care for her family and her parents, who relied on her. Then, her friend suggested she ask her doctor about the test to help her make a more informed decision about whether or not to undergo chemotherapy.
“My Oncotype DX score was a 22 and provided me with information I could count on to create an optimal treatment plan for my cancer, giving me increased confidence to forgo chemotherapy,” said Angela. She recommends checking out www.mybreastcancertreatment.org to learn more about her story and for patient-friendly resources on breast cancer diagnosis and treatment.
While no two breast cancer patients — or their tumors — are alike, there is only one predictive genomic test to help doctors prescribe individualized treatment with definitive information about the benefit of chemotherapy. The test, which is covered by Medicare and most private health insurance providers, can help patients with early-stage breast cancer determine if they are among the approximately 70,000 women each year who can avoid chemotherapy and its unnecessary side effects while still receiving effective treatment.
Patients and caregivers can visit http://www.mybreastcancertreatment.org/ to determine if they are eligible for the test and for resources to help explain treatment options and prepare for appointments.