Fewer Women with Breast Cancer Will Be Getting Chemotherapy

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

Fewer Women with Breast Cancer Will Be Getting Chemotherapy

Results were discussed Sunday at a cancer conference in Chicago and published by the New England Journal of Medicine.

While previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, and women with high scores (above 25) did require and benefit from chemotherapy, there was no conclusive research guiding patients and doctors on whether or not to undergo chemotherapy in cases with a tumor with a midrange score, according to the study.

More than 60,000 women a year in the US could be affected, according to a lead researcher Dr. Joseph A. Sparano of Montefiore Medical Center in NY, and 70 percent of patients who would be potential candidates for chemo could be spared.

A new study finds many women with early-stage cancer may be able to skip chemotherapy.

The current study focused on those whose scores were in the middle range, from 11 to 25.

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

Researchers studied their outcomes, including whether or not cancer recurred, and their overall survival.

The result: After an average follow-up of 7.5 years, the researchers saw no added benefit in this group to adding chemotherapy to the treatment mix. Around half of these patients would historically receive chemotherapy after having surgery to remove their tumour, to prevent recurrence of the disease.

The results "should have a huge impact on doctors and patients", Albain said. "It helps direct patients to the right therapy, so that we're treating the right people with the right therapy at the right time".

According to first author Joseph Sparano of Montefiore Medical Center in NY, "any woman with early-stage breast cancer 75 or younger should have the test and discuss the results" with her doctor.

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Dr Steven Rosenberg, chief of surgery at the National Cancer Institute, which led the trial, told the broadcaster that the therapy remained "highly experimental", but had the potential to transform cancer treatment.

The second study tested a form of immunotherapy against chemo, in the most common lung cancer worldwide, known as non-small-cell lung cancer. "If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers".

This means in practice doctors can tell 70 percent of these patients they don't need to agonize over whether to get chemo, says study co-author Dr. Kathy Albain, a hematology and oncology professor at Loyola University Medical Center in IL. (That mouthful refers to three things: that the cancer was found early, that it could bind to certain hormones and that it didn't have the HER2 receptor.) This type of breast cancer is the most common type, according to the researchers.

Melinda Bachini, a former paramedic who lives in Billings, Montana, believes the treatment saved her life. "They are going to change treatment - and remove uncertainty for women making decisions". 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. However the benefits were unclear for those who fall between which is the vast majority.

"We now know based on the evidence that came out depending on the patient's age there's maybe no benefit to chemo therapy do just as well live as long a life with endocrine therapy", Figueredo said.

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