Saturday, 18 August, 2018

Woman cured of cancer using own immune cells

Participant Adine Usher met last month with study leader Dr. Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in New York Woman cured of cancer using own immune cells
Anna Jefferson | 05 June, 2018, 23:04

All had received a mid-range Oncotype DX score. The side effects are often harsh and debilitating.

"Part of the excitement is because all cancers contain mutations, it's a technique that could potentially be applied to any tumor type", Rosenberg said. The long-awaited results of the TAILORx study, the largest ever breast cancer treatment trial, sponsored by the National Cancer Institute and led by the ECOG-ACRIN Cancer Research Group, were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting by Joseph A. Sparano, MD, professor of Medicine and Obstetrics, Gynecology, and Women's Health at the Albert Einstein College of Medicine; associate chairman for Clinical Research in the Department of Oncology at Montefiore Medical Center; and associate director for Clinical Research at the Albert Einstein Cancer Center.

The results are even more impressive because breast cancers, like prostate and ovarian cancers, have relatively few mutations - which makes it much harder for the immune system to differentiate and attack them.

For the study, more than 10,000 women were given a genomic test for breast cancer called called Oncotype DX, which measures the activity of 21 genes involved in cell growth and predicts the risk that cancer will recur. The presence of hormone receptors in these tumours means that they respond to hormone therapy.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer", said co-author Kathy Albain, an oncologist at Loyola Medicine in a Chicago suburb. Hormone therapy alone was as good as a combination of chemotherapy and hormone therapy in women with an intermediate risk of their cancer returning. "It also helps identify those women with this disease who really do benefit from the chemotherapy they receive", Prof Keane commented.

Previously, the challenge doctors and patients faced was a mid-range score.

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Findings of the past have indicated that women who met these criteria and scored below ten on the index test could safely skip chemotherapy without raising their rate of recurrence, however, those above 25 would nearly always be advised to use chemotherapy as a necessary treatment to lower risk of recurrence.

The Delhi woman's case was typical of that dilemma. She enrolled in the TailorX trial and was relieved to be randomly assigned to the group that did not get chemotherapy. For women, the prospect of losing their breast and then their hair after chemotherapy is extremely scary. "But we need to be precise on when to use it and who to recommend it to". At an incidence rate of 25.8 per 100,000 it is lower than in some developed countries, but the mortality rate (12.7 per 100 000) is comparable to that in western countries principally because of late detection. Key secondary end points included freedom from recurrence of breast cancer at a distant site, freedom from recurrence of breast cancer at a distant or local-regional site, and overall survival (OS).

Oncotype DX is not available in India but samples are sent overseas for the test.

The test costs £2,500 but the NHS gets it at discount.

The mother of two from Florida is enjoying having her old life back and working through a bucket list that she drew up in one of her darker days. "We want to give the right amount", he said. "That is the range that has now been cleared", said Dr Shyam Agarwal, consultant oncologist at Sir Ganga Ram Hospital.

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