A women speaks to a nurse (illustrative photo).
(photo credit: INGIMAGE)
Oncologists at Tel Aviv Sourasky Medical Center are already treating women over 50 with early-stage breast cancer, who have estrogen-positive tumors, with biological drugs instead of chemotherapy.
The efficacy of such therapy – allowing faster recovery, with a higher quality of life and fewer severe side effects – has recently been proven effective by the TAILORx study, just presented at a meeting of the American Society of Clinical Oncology.
The major study, just published in The New England Journal of Medicine
, reverberated around the world earlier this week. A 21-gene-expression test called OncotypeDX measures the activity of genes involved in the recurrence of breast cancer and determines whether a patient will be better off with or without chemotherapy, which is toxic to healthy cells. The test is subsidized if a woman has a supplementary public health fund policy or private insurance.
The major progressive study was launched 12 years ago and eventually encompassed 10,253 women aged 18 to 75. Fully 70% of the participants had scores of 11 to 25 on the gene test and underwent both surgery to remove the malignancy and radiation. They were then assigned randomly to get either endocrine treatment plus chemotherapy or the hormonal treatment alone. The women were followed up for an average of more than seven years.
The researchers found that chemotherapy for this age group and condition had no advantage, as both groups did equally well. After nine years, 93.9% in the endocrine-only group were still alive; 93.8% of those who got the dual treatment also survived.
In the endocrine group, 83.3 % were free of invasive cancer compared with 84.3% who were given both treatments. Chemotherapy was recommended for women under 50, however; the results showed that some of those women would benefit from chemo even if the OncotypeDX test had low results; why this is so is not yet understood by oncologists.
“We at the breast unit in the oncology system at Sourasky’s Ichilov Hospital are working according to the principles outlined in this study and similar studies done in the past,” said Dr. Amir Sonnenblick, head of the breast cancer unit at Sourasky. “Indeed, most of the patients treated with estrogen receptor-positive tumors avoid chemotherapy and make do with hormonal therapy. Today, most of our breast cancer patients who are positive for the receptors are able to avoid chemotherapy after surgery to remove the tumor.”