New multi-gene test helps a few breast cancer patients skip chemotherapy

The study focuses on the most common type of breast cancer: early stage that is hormone positive. The tumor’s growth is being fueled by estrogen or progesterone.

“It is among the most delicate and hard dilemmas in medicine: Should a pregnant woman who has received a cancer diagnosis begin treatment before her child is born?” the NYT piece stated.

Genomic Health Inc.GHDX recently announced the initial results of a multi-center trial named T rial A ssigning I ndividua L ized O ptions for Treatment (Rx), or TAILORx, which validated the clinical utility of Genomic’s Oncotype DX test to risk-classify patients suffering from early stage breast cancer.

Eighty-nine of the children were exposed to chemotherapy before birth, four to radiotherapy, seven to both chemo- and radiotherapy, 13 to surgery and one each to the drugs cancer drugs Herceptin and interferon beta.

The research team was amazed by the finding as Dr. Joseph Sparano, field expert working at the Montefiore Medical Center, New York, and the study’s lead author, offered a statement informing that “You can’t do better than that”.

Dr. Karen Beckerman, a New York City obstetrician diagnosed with breast cancer in 2011, said she has undergone the gene test as suggested by a Doctor and she scored very low for recurrence risk.

“There is really no chance that chemotherapy could make that number better”, he said.

In HER2-negative breast cancer with favorable gene-expression profile, patients may have low rates of recurrence at 5 years. He was not involved in the study, however he agrees with Dr. Sparano.

While the study is ongoing in order to further evaluate whether chemotherapy is effective for reducing breast cancer recurrence among intermediate- and high-risk groups, independent reviewers of the study recommended the results for the low-risk group be released early. The test basically provides doctors with nearly 100 percent certainty regarding the women who don’t need chemotherapy.

The study, published in The New England Journal of Medi cine, was presented on Monday at the European Cancer Congress in Vienna.

The study also showed that children of mothers with cancer in pregnancy suffer more from prematurity, regardless of whether they are exposed to prenatal cancer treatments. Additionally, the test predicts the likelihood of recurrence in a pre-invasive form of breast cancer called DCIS. Women in the middle group were randomly assigned to get hormone therapy alone or to add chemotherapy. Though cancer in pregnancy is rare, about 1 in every 1,000, this study is important in caring for the baby as well as the mother’s health.

Although its price is $4,200, most insurers cover it. The recent study was necessary to confirm that the test is accurate when it assesses the risk of cancer relapse.

Others besides Oncotype are on the market and that’s considered good news as well.