Saturday, 18 August, 2018

Chemotherapy is not needed in 70% of cases of breast cancer

Chemotherapy is not needed in 70% of cases of breast cancer Chemotherapy is not needed in 70% of cases of breast cancer
Anna Jefferson | 05 June, 2018, 19:43

The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs.

"Every day, women with certain types of breast cancer face the bad dilemma of whether or not to have the treatment, without hard facts about the benefit for them".

Hormone-receptor-positive, axillary node-negative disease accounts for approximately half of all cases of breast cancer in the USA, and the National Institutes of Health has previously recommended adjuvant chemotherapy for most patients, the authors write.

While previous studies demonstrated that patients with low scores (ten 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 tumour with a midrange score, according to the study.

Watch the full story above.

But an immune breakthrough for bowel, breast and ovary cancer has remained elusive. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer [published online June 3, 2018]. By finding, isolating and multiplying the tiny subset of immune cells that are still in the fight, then demonstrating their ability to vanquish a patient's tumors, Rosenberg's group has shown that "the cells are there", Mackall said.

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", said Tom Misteli, director of CCR at NCI.

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Around half of these patients would historically receive chemotherapy after having surgery to remove their tumour, to prevent recurrence of the disease. The tumor is assigned a "recurrence score" from 0 to 100; the higher the score, the greater the chance the cancer will recur in distant organs and decrease survival.

Now, it's much more common to tackle the disease with gene-targeting therapies, hormone blockers and immune system treatments.

All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. More studies are needed to look at those groups of women, they said. "The study showed that if you take the group as a whole, there is no difference in the risk of recurrence when you compare chemotherapy to no chemotherapy". Of the 10,273 women tested, 6,711 (69%) had a score of 11-25. A key part - the initial $4.5 million of the cancer institute's $36 million contribution - came from the stamp, said Dinah Singer, who is involved in the institute's use of stamp proceeds.

In this case study, they identified 62 mutations, and then tested samples of Perkins' tumour-infiltrating lymphocytes (TILs) - a form of white blood cell primed to identify and destroy mutated cells - to find those that were particularly active against cells with one or more mutations.

Researchers at the National Cancer Institute have put a patient with metastatic breast cancer into complete remission using a new approach to immunotherapy.

Previous trials involving cancer immunotherapy have found that it "tends to work spectacularly for some patients, but the majority do not benefit", the BBC reports.

Still, he acknowledged that most patients with this form of advanced cancer will die within months, and "we need to do a lot more work".

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