Arabic version: اختبار جيني جديد قد يلغي العلاج الكيميائي للعديد من مرضى سرطان الثدي
Millions of women with breast cancer could be spared chemotherapy with a groundbreaking genomic test, according to the results of a trial that could transform healthcare guidelines worldwide. Treatment for breast cancer, the world’s most prevalent form of the disease, involves surgery to remove tumours. Chemotherapy is then usually recommended when doctors believe there is a risk the disease will return.
According to The Guardian, results from an international trial of the test suggest millions of women could safely avoid chemotherapy, sparing them side-effects without increasing the risk of their cancer returning. The findings will be presented at the American Society of Clinical Oncology’s annual meeting in Chicago on Saturday. The Optima trial, led by University College London, followed more than 4,429 patients with newly diagnosed hormone-positive breast cancer in the UK, Norway, Sweden, Australia, New Zealand, and Thailand. It found that those with a low score on the genomic test could be treated safely with hormone therapy alone.
The genomic test, made by the global diagnostics company Veracyte, analyses the activity of 50 genes in tumour tissue. It determines the molecular subtype and provides a score revealing the risk of breast cancer returning in the next decade, helping doctors decide if chemotherapy is worthwhile or not. Participants were assigned to one of two treatment groups. In the standard treatment group, patients received chemotherapy followed by hormone therapy. In the second group, patients had their tumours analysed with the genomic test. Those with a high score received chemotherapy and hormone therapy. Those with a low score were treated with hormone therapy alone. Radiotherapy and other treatments were given as usual to both groups.
In the second group, results showed outcomes were extremely similar whether chemotherapy was given or not. Five years after treatment, 95% of those who had chemotherapy and hormone therapy were alive and free from breast cancer recurrence, while 94% of those who skipped chemotherapy were also alive and recurrence-free. Prof Rob Stein, the trial’s chief investigator and a professor of breast oncology at UCL, said: “Optima addresses a longstanding challenge in breast cancer care: identifying who truly benefits from chemotherapy and who does not. Our findings show that many patients can safely avoid chemotherapy without compromising their outcomes.”
The trial’s implications extend beyond individual patients, as it signals a shift towards evidence-based practices in cancer treatment. Prof Iain MacPherson, a co-chief investigator and professor of breast oncology at the University of Glasgow, highlighted the potential for substantial benefits to both patients and healthcare systems, advocating for a more precise approach to breast cancer care.
