Judy Perkins had hormone receptor-positive breast cancer that had spread to her liver and other organs and had exhausted all other treatment options, including several rounds of chemotherapy, and none had stopped the disease progressing. Previous studies had made clear that women with low scores could skip chemotherapy and those with high scores should get it.
Big news for some women who have breast cancer.
Dr Steven Rosenberg, who led the trial by the US National Cancer Institute, said.
The findings could be a game-changer in breast cancer care, researchers and experts said. By continuing the personalized assessment of an individual's cancer recurrence risk, oncologists can more effectively determine specifically-tailored treatments based on that patient's genomic results. The money was used to pay for the gene test, which costs more than $4,000 per person. So they don't have to receive chemotherapy. They represent roughly half of the more than 17,000 new cases of breast cancer diagnosed in Australia every year.
"The impact is tremendous", said the study's leader, Dr. Joseph Sparano of Montefiore Medical Center in NY.
Judy, who lives in Florida had an aggressive form of advanced cancer where her major organs were getting involved and there was no scope for treatment with conventional methods such as a chemotherapy, surgery and radiation therapy.
"As an oncologist, on Monday in the clinic, I will offer less chemotherapy that will not be of benefit to patients and that is very reassuring to know that when I am offering patients chemotherapy, they are likely to benefit from it".
Thousands of women have been tested over the years using Oncotype DX to help determine the true effectiveness of chemo. The side effects are often harsh and debilitating.
The findings will lead to a "fundamental change" in the way the disease is treated, a leading oncologist said, with an estimated 3,000 to 5,000 United Kingdom women likely to avoid chemotherapy every year as a result.
In addition, a recent study says chemo does not improve survival, that most women can be safely treated with just surgery and hormone blockers.
Judy Perkins, 52, had received a number of failed treatments when she joined a study trialling a new kind of therapy.
Cancer Trials Ireland CEO, Eibhlin Mulroe, added that the fact that so many women in Ireland were able to take part in this trial "demonstrates the world-class capability of our unique network of cancer trials research units spread across Ireland". Rates for freedom from disease recurrence at a distant site were also similar, at 94.5% and 95% for the endocrine therapy and chemoendocrine therapy groups, respectively, as were rates for freedom from disease at a distant or local-regional site (92.2% and 92.9%, respectively) and for overall survival (93.9% vs 93.8%.).
Over the years, the Cancer Institute has used its $59.8 million in proceeds for studies trying to improve early detection and to determine which cancers are most unsafe and need heaviest treatment and which are less so.
However, among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group, so in those cases, doctors may urge patients to consider a chemo regimen. That doctors and researchers need to constantly re-evaluate the assumptions on which medical decisions are based, especially for something as important and time-sensitive as cancer treatments.