Study: Some breast cancer patients can be treated without chemo

Study: Some breast cancer patients can be treated without chemo

A DNA test  test 'can be used to inform treatment decisions for women with more advanced hormone-driven cancers'. Picture: Stock image

A new breast-cancer study confirms most women with a common form of the disease can skip chemotherapy if a DNA test indicates it would not benefit them.

The study, published in the New England Journal of Medicine this week, included 250 Irish women among 5,018 participants around the world.

It confirms that postmenopausal women with a type of cancer called Early Stage ER+ Node Positive breast cancer can be safely treated without using debilitating chemotherapy.

Around 3,500 women are diagnosed with breast cancer in Ireland every year, and two-thirds of women diagnosed with this particular type of cancer are post-menopausal.

The genetic tests tell researchers the likely recurrence of breast cancer, and the potential benefit of chemotherapy

They are already part of the HSE’s national cancer control programme for other cancers.

“Irish oncologists have been using the Oncotype DX test for many years now in women with node negative cancers to individualise treatment,”  said Professor Cathy Kelly, co-author on the RxPONDER study and oncologist at the Mater Hospital.

Now the test can be used to inform treatment decisions for women with more advanced hormone- driven cancers.

She said postmenopausal women could now receive only hormone therapy, and skip the discomfort, potentially harmful side-effects, and expense of chemotherapy following assessment.

“The trial showed that for postmenopausal women with hormone-driven breast cancer, that involved up to three lymph nodes who had a recurrence score of less than 26, did not benefit from chemotherapy,” Prof Kelly said.

“These women did as well as women who just received a hormone-blocking tablet. The trial showed absolutely no difference in recurrence of breast cancer with or without chemotherapy in this group of women.” 

However, the study found that young pre-menopausal women did benefit from chemotherapy compared to those who did not receive it.

For these younger women who benefit from chemotherapy, Prof Kelly said: “The data helps individualise the discussion of risk and benefit of chemotherapy.” 

The Irish women who volunteered for the study, through Cancer Trials Ireland, played a major role contributing to these “practice-changing results”, she said.

“As an Irish breast medical oncologist, I am very proud that Ireland has contributed to this really important and meaningful trial and I am privileged to be the Irish Lead Investigator for the study,” Prof Kelly said.

I would like to thank all the women who bravely and selflessly took part in the study and to my breast oncology colleagues who ensured women across Ireland had access to the study.

This follows early trial results indicting the benefits of these tests for post-menopausal women late last year, and research published in June 2020 which showed that 69% of women with breast node negative cancer could also safely avoid chemotherapy.

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