Extended Research Has Been Done On A Gene Test That Helps Some Breast-Cancer Patients Determine If They Can Safely Forgo Chemo

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A gene test used to guide treatment for early-stage breast cancer proved effective in enabling certain women to safely forgo chemotherapy, in a study that illustrates how genomic information is reshaping cancer care. Researchers said the findings provide validation for the test, called Oncotype DX, which is already in use helping women decide whether chemotherapy should be part of their treatment. The test provides a score based on a tumor’s genetic signature that describes the risk that the cancer will recur.

Oncotype DX analyzes 21 genes in the tumor to estimate a woman’s risk of the cancer coming back after surgery.

For patients who fell into the test’s low-risk category, 99 percent didn’t develop metastatic breast cancer five years after surgery, even though they didn’t have chemotherapy. The overall survival rate among this group was 98 percent, doctors reported in the New England Journal of Medicine.

“We knew these patients were going to do well, but we didn’t dream they would do this well,” said Joseph Sparano, associate chairman of medical oncology at Montefiore Medical Center and Albert Einstein College of Medicine in Bronx, N.Y., and lead author of the study.

Jennifer Litton, a breast medical oncologist at University of Texas MD Anderson Cancer Center in Houston, who wasn’t a researcher on the study, said she is eager to see results for patients in the midrange, where earlier data are ambiguous. “That’s the tougher conversation with patients,” she said. The current findings provide assurance for oncologists who already use the test to guide treatment of low-risk patients. “This is a group of patients that we are likely over-treating with chemotherapy,” Dr. Litton said. “Using this test we can spare these patients from chemotherapy.”

“This is very reassuring that the guidelines we’ve been following are right,” says Dr. Daniel Hayes, who co-directs the Breast Oncology Program at the University of Michigan and contributed to the current study. “It’s one more step forward to personalizing how we treat patients.”

But, for a large percentage of patients, the Oncotype DX test is still ambiguous, Hayes says. Nearly 70 percent of the patients in the study scored in the mid-range of the test and were considered a moderate risk for a relapse.

Hayes and his colleagues are now testing to see which of these patients benefit from chemotherapy. The results of that trial are due out in a few years.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • cathy sikorski

    Ellen, a million thanks for this, I lost a sister to breast cancer. And now one of my very best friends is having a lumpectomy tomorrow, I’m forwarding this to her as we speak. I’m so grateful for people like you who navigate the info and keep us informed.

  • What incredibly important work you’re doing here. Thank you for sharing all that you have learned.

  • sheryl

    This is such important information for women who might be able to avoid unnecessary chemotherapy. Things have changed so drastically since I was diagnosed over 20 years ago, when chemo was given prophylactically, “just in case.”

    • Wow, Sheryl, 20 years ago. Happy to hear that! Yes, I am hoping that this study further validates the use of the Oncotype DX in helping to make these very important healthcare decisions. This is why it is important information for women to know about. We need to be educated about our options so that we can be able to discuss these options with our medical practitioners.

    • cathy sikorski
  • Kim Dalferes

    Thx so much for sharing this information. Making informed decisions about treatment options must be a top priority for everyone involved in a woman’s care.

  • Cheryl Nicholl

    OMG! My Mom had this test and didn’t need chemo!! All is well 10 years later! Wonderful news!!

  • Helene Bludman

    It is so good to have this important information. Thank you, Ellen, for keeping us up to date on what is happening in the field.

  • I didn’t know about this, and now I do, so thank you. It’s really great news and you’re right, this kind of research is critical to developing the right protocols. I do count onyou to tell me what’s new and interesting…

  • 1010 Park Place

    Thank you for telling women about Oncotype DX. I’m an 11-year breast cancer survivor who took the test and was told I needed chemo. Big things continue to happen in the breast cancer research community, especially those research teams funded by Stand Up to Cancer. If you’re interested, here’s my conversation with Sherry Lansing about SU2C. What an amazing woman! Thanks, Brenda http://www.1010parkplace.com/an-important-conversation-with-sherry-lansing/