Joel Savage en A trendy life, Communications and journalism, Healthcare Freelance Journalist, writer and author • A MIXTURE OF PERIODICALS 8/11/2016 · 1 min de lectura · +100



Complete hair loss after chemo, yet breast cancer survivors always wear beautiful smile on the face

According to new research, published in the New England Journal of Medicine, nearly half of all women with early stage breast cancer may undergo chemotherapy unnecessarily.

In 46% of the breast cancer cases that were classified as having a high risk for recurrence using a conventional assessment method, in fact, had a low risk of recurrence when assessed using a genetic test called MammaPrint. Patients at high risk of recurrence have to undergo chemotherapy.

Low-risk gene profile

These results, obtained from a large international study called the MINDACT trial, confirmed the results of a study published by Stellenbosch University (SU) researchers in 2013 which showed safe avoidance of chemotherapy in those shown to have a low-risk gene profile.

“The MINDACT trial validated our findings and we feel confident to say that it is important for oncologists to consider this 70-gene test in the design of a patients’ treatment plan,” says Maritha Kotze, a professor in genetics at the SU faculty of medicine and health sciences and the National Health Laboratory Service, Tygerberg Hospital.

Reducing costs and side effects
Forgoing chemotherapy does not only cuts the cost of treatment considerably (chemotherapy costs more than R100,000) but spares patients the side effects associated with the treatment.

“Chemotherapy is a lifesaver for those who need it, but could cause nausea, hair loss, and many other complications, so patients shouldn’t have to undergo it unnecessarily,” says Dr. Kathy Grant, the lead author of the 2013 MammaPrint study at SU.

Trial results

The MINDACT trial studied the risk of recurrence in 6,693 women with early-stage breast cancer. Their risks of recurrence were determined using a method routinely used in clinical settings (Adjuvant! Online, which calculates the clinical risk based on the type, size and other characteristics of the tumor), as well as with the MammaPrint test (which determines a genomic risk using a 70-gene signature).

Within the group of 6,693 women, 1,550 (23,2%) had a high clinical risk, but a low genomic risk. The women received no chemotherapy, and after five years, 94,7% had no recurrence of the disease.

“Among women with early-stage breast cancer who were a high clinical risk, but with a low genomic risk for recurrence, not receiving chemotherapy on the basis of the 70-gene signature led to a five-year rate of survival without distant metastasis (recurrence) that was 1,5 percentage points lower than the rate with chemotherapy. Given these findings, approximately 46% of women with breast cancer who are at high clinical risk might not require chemotherapy,” the authors of the MINDACT trial concluded.

Only patients with early-stage breast cancer (stage 1 or 2) were considered for the study.

Value of genetic profiling

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