CDI Miami | Tuesday September 29, 2015

Chemotherapy May Not Be Needed for Early-Stage Breast Cancer

A recent study shows that early-stage tumors may respond to drug-therapy alone

Researchers from the New England Journal of Medicine (NEJM) reported the strongest evidence yet that some women with early stage breast tumors may not need chemotherapy to effectively treat their cancer.


“For some women, hormone-based anti-tumor drugs may be all they need to enjoy 98% survival at five years and a 93.8% chance of being free of invasive breast cancer in that time as well.” Time Magazine


A new gene-based test called Oncotype Dx, scans 21 genes in the tumor to create a profile of the tumor’s strengths and weaknesses. This information is essential in helping doctors determine the potential aggressiveness of a tumor.


“What we’ve shown is that if you have a low recurrence score, you do really, really well with [hormone] therapy alone,” says Dr. Joseph Sporano, associate chairman of the oncology at Montefiore Medical Center and lead author of the study. “The likelihood of responding to chemotherapy would be nill. So I think we can be much more confident in making the recommendation to just use [hormone] therapy alone especially in patients where we might have been a little skittish about recommending sparing chemotherapy.”


The findings should help cancer doctors to have more confidence in recommending that certain women skip chemotherapy, but Sporano admits that this might be a difficult hurdle to overcome. First, the test isn’t universally used, since it costs $3,500. Doctors tend to rely on the assay when they want more information before deciding whether to recommend chemotherapy to their patients. And the instinct to rely on logical features, such as the tumor’s size and grade, may be too strong to challenge. “There may be a tendency to discount the results of the recurrence scores in patients who are younger and with larger tumors or higher grade tumors,” he says. “But the results of this study suggest that information should not be discounted. These patients can do really, really well with this information.”