This US postal stamp helped fund key breast cancer study

Adine Usher 78 meets with breast cancer study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in the Bronx borough of New York. Usher was one of about 10,000 participants in the study which shows women at low or inter

Dr Alistair Ring, consultant medical oncologist at the Royal Marsden NHS Hospital, in London, said: "I think this is a fundamental change in the way we treat women with early-stage breast cancer and will lead to a considerable number of women no longer needing to have chemotherapy".

The study, published June 3 in the New England Journal of Medicine, finds that most patients with an intermediate risk of cancer recurrence can skip chemotherapy treatment without affecting their chances of surviving the disease. Researchers say, the results allowed them to separate women who would benefit from chemotherapy due to a higher risk of recurrent breast cancer, and those who tested at a lower risk and do not need chemo for treatment.

The TAILORx trial was created to help personalize treatment for women 18 to 75 years of age with hormone receptor (HR)-positive, HER2-negative, axillary node (AN)-negative breast cancer whose tumors were 1.1 cm to 5.0 cm in size and who had a mid-range RS. For women aged under 50 with scores of 16-25, there was some benefit in getting chemotherapy, but for those aged over 50 with scores under 25, or those aged under 50 and scores below 16, there was nothing to be gained from going through the draining process.

A new USA study, TAILORx, has shown that up to 70% of these women could avoid this painful treatment, which has multiple side effects.

"But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer". The 67 percent of women who were at intermediate risk all had surgery and hormone therapy. "We now can identify a larger group of women who can avoid chemotherapy and just give anti-estrogen therapy and get the same results", she said.

"Irish women contributed significantly to this trial and can be rightly proud of their input into improving care for future women who present with breast cancer".

The patients then went on to receive either hormonal therapy alone or the combo of hormonal therapy plus chemotherapy.

The study used a gene test done on tumors to help decide whether a woman would benefit from chemo or if they could receive hormone therapy. "I've been anxious for a long time about unnecessary treatment for cancer, and unnecessary side effects from chemotherapy".

Very high scores are at increased risk of the cancer spreading, and those patients have benefited a lot by chemotherapy. It took place over the last ten years and followed over ten thousand women.

In this study, nearly 7,000 women had scores between 11 and 25. Their study showed, for example, that chemotherapy use in patients whose cancer had not spread to the lymph nodes declined from 26.6 percent in 2013 to 14.1 percent in 2015.

The second study tested a form of immunotherapy against chemo, in the most common lung cancer worldwide, known as non-small-cell lung cancer. The rates of invasive disease-free survival at 9 years were similar for both groups, at 83.3% for the endocrine-therapy group and 84.3% for the chemoendocrine therapy group. After years of follow-up, the data showed that most patients who did not get chemotherapy fared as well as those who did.

A sample of the tumour is tested after surgery for 21 genetic markers, which indicate if it could grow and spread.

These women would instead be treated with radiation, surgery, and hormone therapy.

Dr. Albain, the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine, has conducted research with the 21-gene test and also used it in her practice for years.

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