Page 28 - ARUBA TODAY

A28 SCIENCE
Tuesday 5 June 2018

Many breast cancer patients can skip chemo, big study finds

By MARILYNN MARCHIONE All women like those in
Associated Press the study should get gene
CHICAGO (AP) — Most testing to guide their care,
women with the most said Dr. Richard Schilsky,
common form of early- chief medical officer of
stage breast cancer can the oncology society.
safely skip chemotherapy Oncotype DX costs around
without hurting their $4,000, which Medicare
chances of beating the and many insurers cover.
disease, doctors are Similar tests including one
reporting from a landmark called MammaPrint also
study that used genetic are widely used.
testing to gauge each Testing solved a big
patient's risk. problem of figuring out
The study is the largest ever who needs chemo, said
done of breast cancer Dr. Harold Burstein of the
treatment, and the results Dana-Farber Cancer
are expected to spare up Institute in Boston. Many
to 70,000 patients a year women think "if I don't get
in the United States and chemotherapy I'm going
many more elsewhere the to die, and if I get chemo
ordeal and expense of I'm going to be cured," but
these drugs. the results show there's a
"The impact is tremendous," sliding scale of benefit and
said the study leader, sometimes none, he said.
Dr. Joseph Sparano of Dr. Lisa Carey, a breast
Montefiore Medical Center specialist at the University of
in New York. Most women North Carolina's Lineberger
in this situation don't need Comprehensive Cancer
treatment beyond surgery Center, said she would be
and hormone therapy, he very comfortable advising
said. In this Thursday, May 24, 2018 photo, Adine Usher, 78, meets with breast cancer study leader Dr. patients to skip chemo if
Joseph Sparano at the Montefiore and Albert Einstein College of Medicine in
The study was funded the Bronx borough of New York. they were like those in the
by the National Cancer Associated Press study who did not benefit
Institute, some foundations from it.
and proceeds from the periods or lower doses than surgery followed by years based on earlier results Dr. Jennifer Litton at MD
U.S. breast cancer postage it once was. of a hormone-blocking from this study. Anderson Cancer Center
stamp. Results were For example, another drug. But many women The new results are on the in Houston, agreed, but
discussed Sunday at an study at the conference also are urged to have 67 percent of women at said: "Risk to one person is
American Society of Clinical found that Merck's chemo to help kill any stray intermediate risk. All had not the same thing as risk
Oncology conference in immunotherapy drug cancer cells. Doctors know surgery and hormone to another. There are some
Chicago and published by Keytruda worked better that most don't need it, but therapy, and half also got people who say, 'I don't
the New England Journal than chemo as initial evidence is thin on who chemo. care what you say, I'm
of Medicine. Some study treatment for most people can forgo it. After nine years, 94 percent never going to do chemo,'"
leaders consult for breast with the most common The study gave 10,273 of both groups were still and won't even have the
cancer drugmakers or for type of lung cancer, and patients a test called alive, and about 84 percent gene test, she said. Others
the company that makes with far fewer side effects. Oncotype DX, which uses a were alive without signs of want chemo for even the
the gene test. The breast cancer study biopsy sample to measure cancer, so adding chemo smallest chance of benefit.
MOVING AWAY FROM focused on cases where the activity of genes made no difference. Adine Usher, 78, who lives
CHEMO chemo's value increasingly involved in cell growth Certain women 50 or in Hartsdale, New York,
Cancer care has been is in doubt: women with and response to hormone younger did benefit from joined the study 10 years
evolving away from early-stage disease that therapy, to estimate the risk chemo; slightly fewer ago at Montefiore and was
chemotherapy — older has not spread to lymph that a cancer will recur. cases of cancer spreading randomly assigned to the
drugs with harsh side nodes, is hormone-positive WHAT THE STUDY FOUND far beyond the breast group given chemo.
effects — in favor of (meaning its growth is About 17 percent of occurred among some "I was a little relieved. I
gene-targeting therapies, fueled by estrogen or women had high-risk scores of them given chemo, sort of viewed chemo as
hormone blockers and progesterone) and is not and were advised to have depending on their risk extra insurance," she said.
immune system treatments. the type that the drug chemo. The 16 percent scores on the gene test. The treatments "weren't
When chemo is used now, Herceptin targets. with low-risk scores now WILL PEOPLE TRUST THE pleasant," she concedes.
it's sometimes for shorter The usual treatment is know they can skip chemo, RESULTS? Her hair fell out, she
developed an infection
and was hospitalized for a
low white blood count, "but
it was over fairly quickly
and I'm really glad I had it."
If doctors had
recommended she skip
chemo based on the
gene test, "I would have
accepted that," she said.
"I'm a firm believer in
medical research."q