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1 in 4 women on study avoided chemotherapy 

Congratulations to Dr Patrick Morris, Consultant Medical Oncologist at Beaumont Hospital Dublin, and his team for presenting exciting results of the Cancer Trials Ireland sponsored  Gene Recurrence Score Study at ESMO2018.

Pictured at the poster presentation at ESMO2018 Dr Anees Hassan, Dr Verena Murphy and Dr Kathleen Scott.

1 in 4 women on breast cancer study avoided chemotherapy 

An Irish cancer study has found that participating oncologists recommended that 1 in 4 women whose early-stage breast cancer had spread to their lymph nodes did not need chemotherapy.

The recommendation was based on the results of a genomic test which indicated which women were at low risk of their tumour relapsing and had tumours, which were relatively resistant to chemotherapy.

The results of the study, sponsored by Cancer Trials Ireland, were presented today (22nd October 2018) at the Annual Congress of the European Society for Medical Oncology (ESMO) in Munich, Germany.

ESMO is the leading European professional organisation for medical oncologists and the Annual Congress attracts more than 20,000 participants from around the world.

CTRIAL-IE 15-34 study, titled ‘The impact of the 21 Gene Recurrence Score (RS), on Chemotherapy Prescribing in Estrogen Receptor Positive, Lymph Node Positive Early Stage Breast Cancer in Ireland’, was led by Dr Patrick Morris, Consultant Medical Oncologist at Beaumont Hospital Dublin, and sponsored by Cancer Trials Ireland.

Dr Morris said “This study adds important information about how this test can help oncologists advise on the benefits of chemotherapy. Our results show that a quarter of patients with node positive early stage breast cancer avoided chemotherapy after Oncotype testing. This study will hopefully lead to greater individualised care in Ireland in the future. Our ongoing research is examining whether this test can be used in patients before breast cancer surgery”.

The study involved 74 patients from hospitals in Dublin, Cork, Letterkenny, Limerick, Galway and Waterford.

It used the 21 Gene Recurrence Score gene test (OncotypeDx®) to examine the tumour genes of participating patients to estimate the risk of a tumour relapsing and possible chemotherapy benefits.

Currently, the test is reimbursed in Ireland for some patients with early-stage breast cancer which has not spread to their lymph nodes. This study extended this to patients whose cancer had spread to their lymph nodes.

From the 74 patients included in the analysis, the study found that in 64% of cases, oncologists thought the tests result substantially changed chemotherapy recommendations. In particular, the test led to a 27% reduction in the recommendation for chemotherapy from 68 (92%) to 48 (65%) patients.

Background

After a breast cancer and any lymph glands have been surgically removed, further, (adjuvant) treatment is generally given to reduce the risk of cancer recurrence. For patients with estrogen receptor (ER) positive breast cancer, this treatment has traditionally been chemotherapy and hormone therapy. However, it is increasingly recognised that tumours which are ER positive and negative for the human epidermal growth factor receptor 2 (HER2), are relatively resistant to chemotherapy. It is likely that many more people are exposed to the risks for chemotherapy than ever benefit from it. In order to select patients who will get more benefit from chemotherapy and to spare those who get very little benefit from side effects, risk assessment tools have been developed. The 21 gene Recurrence Score (OncotypeDx®) is one such assessment tool. It can predict the likelihood of chemotherapy benefit for women with breast cancer as well as the risk of recurrence in early-stage breast cancer. Although chemotherapy has been routinely offered to patients with ER positive disease, research shows that only a minority of patients with early-stage breast cancer actually benefit from it.