A revolutionary genetic test may give millions of breast cancer patients the chance to avoid chemotherapy
The data of a new study carried out by a prestigious university in London gives hope for the opening of a new era of personalized medicine for breast cancer patients, according to The Guardian.
Currently, treatment for breast cancer, the most common form of the disease worldwide, involves surgery to remove tumors. Chemotherapy is recommended when doctors think there is a risk that the disease will come back.
Side effects of chemotherapy include hair loss, skin rashes, nausea, insomnia and fatigue. They affect patients physically and emotionally. Some women experience long-term problems such as infertility, cognitive impairment or early menopause.
For decades, patients had few treatment options. Now scientists have developed a genomic test that can identify who needs chemotherapy and who doesn't. This discovery allows doctors to determine which patients can safely stop chemotherapy.
The results of this international study suggest that millions of women can safely forgo chemotherapy, avoiding side effects without increasing the risk of cancer recurrence.
What the results of the study show
The Optima study, led by University College London (UCL), followed more than 4,000 newly diagnosed breast cancer patients in the UK, Norway, Sweden, Australia, New Zealand and Thailand. It has been found that those with a low score on the genomic test can be safely treated with hormone therapy alone.
One woman who took part in the study told The Guardian that being able to give up chemotherapy was “like a Christmas present”. Nine years after she was diagnosed, she is healthy and enjoying a full and active life, chemotherapy-free.
“Optima addresses a long-standing challenge in breast cancer treatment: identifying patients who really benefit from chemotherapy and those who do not. Our results show that many patients can safely forgo chemotherapy without compromising their treatment outcomes,” said Professor Rob Stein, study coordinator and professor of breast oncology at UCL.
The expert says the results represent an important and significant step towards more personalized treatment. “The study successfully used tumor biology to guide decisions, rather than relying solely on traditional clinical features.
“For patients, this means that many of them could be spared the physical and emotional burden of chemotherapy and its potential long-term side effects. For health systems, this represents a more efficient and evidence-based use of resources,” he explained.
How the test works
The test used is called Prosigna and is made by the American company Veracyte. It analyzes the activity of 50 genes in tumor tissue to determine the risk of cancer recurrence over the next decade, helping doctors decide whether chemotherapy is useful or not.
4,429 patients over the age of 40, diagnosed with hormone-positive breast cancer, participated in this study. This is the most common form of the disease and accounts for up to 80% of cases worldwide.
The patients were divided into two treatment groups. In the first group, the treatment was the standard one: chemotherapy followed by hormone therapy. In the second group, the approach depended on the genomic test.
Those with high scores received chemotherapy and hormone therapy, and those with low scores received only hormone therapy. Radiotherapy and other treatments were routinely administered to both groups.
Among the patients in the second group, the data were similar, regardless of whether chemotherapy was administered or not. Five years after treatment, 95 percent of those who received chemotherapy and hormone therapy were alive and free of relapses. At the same time, 94% of those who stopped chemotherapy were also alive and had no recurrence of the disease.
The results suggest that for people with low scores, chemotherapy provided little or no benefit, allowing the treatment and its side effects to be avoided.
Men also participated in the study, but their numbers were too small to draw firm conclusions.
“Optima provides robust, practice-changing evidence that we can safely reduce the use of chemotherapy for many patients with hormone-sensitive breast cancer,” said Professor Iain MacPherson, co-coordinator of the study and professor of breast oncology at the University of Glasgow.
“These findings are an important step towards delivering more personalized and accurate care, ensuring that treatment decisions are driven by what will truly improve outcomes for patients, while avoiding unnecessary toxicity. The potential impact for both patients and health services is substantial,” he added.
The findings are being presented Saturday at the annual meeting of the American Society of Clinical Oncology in Chicago, the world's largest cancer conference. The research was funded by the UK's National Institute for Health and Care Research, Veracyte and charities.
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