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Chemotherapy can be avoided with common breast cancer

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Participant Adine Usher met last month with study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in New York

The trial focused on HR positive, HER2-negative, node-negative breast cancer, which is the most common type of early stage breast cancer.

More than two years on, she is cancer-free and says she has "gone back to normal everyday life", even enjoying strenuous hiking and kayaking trips.

Cancer doctors said the findings would change practice in United Kingdom clinics, and meant women in this group could be treated safely with just surgery and hormone therapy. And while this finding certainly doesn't eliminate chemotherapy as a viable tool, it very likely means that a huge number of patients will have the opportunity to receive more personally-tailored treatments in the future.

Oncotype Dx is a test created to predict the risk of breast cancer coming back. But this decision is being reviewed.

This form of immunotherapy has frustratingly been inconsistent in early clinical trials, working well with some patients on certain cancers but proving less effective on others.

What did the study show?

But the best treatment for those with a score in the middle has been unclear.

Women with early-stage breast cancer tend to have high survival rates, but their outlook worsens tremendously if the cancer returns to other parts of the body.

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Women with scores of 10 or lower were considered not to need chemotherapy while those with scores 25 and over were considered to need it.

Scientists found that giving hormone therapy alone was as good as the combination of chemotherapy and hormone therapy in women with the intermediate score.

Trial Assigning IndividuaLized Options for Treatment (Rx), or TAILORx, successfully confirmed the benefit of endocrine therapy alone in patients with early-stage breast cancer who have an Oncotype DX Breast Recurrence Score of 11 to 25.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 per cent of patients who are diagnosed with the most common form of breast cancer", said Dr Albain. Should we give them chemotherapy?

Perkins, who lives in Port Lucie, Florida, sent two friends with breast cancer to Rosenberg's lab and both of them died despite the treatment - one of them with severe side-effects from the treatment itself, she said. "You're never going to see these kinds of trials from the drug companies", because what is being tested might result in less use of their products, Brawley said. Using this test, researchers found that chemotherapy did not add any benefit in survival rates or recurrence for most women. "It helps direct patients to the right therapy, so that we're treating the right people with the right therapy at the right time". The new study provides the highest level of proof that the assay is an accurate tool and thus reduces uncertainty for the intermediate group, said Dawn Hershman, a breast oncologist at NewYork-Presbyterian Columbia University Medical Center.

Where did these results come from?

The findings, to be presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, are based on based on a comprehensive review of data from The Cancer Genome Atlas (TCGA), the world's largest public database containing genetic information about various different types of tumors.

These are the results from a single patient and much larger trials will be needed to confirm the findings.

A patient's tumour is genetically analysed to identify the rare changes that might make the cancer visible to the immune system.

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