Genomic test could allow breast cancer patients to skip chemotherapy, trial finds
The Story
According to a single-source report from the Guardian, the results of an international trial called Optima, led by University College London, suggest that a genomic test can identify which breast cancer patients can safely avoid chemotherapy without increasing the risk of recurrence. The test, called Prosigna, analyzes 50 genes in tumor tissue to produce a score predicting the likelihood of cancer returning in the next decade. The trial followed 4,429 patients with hormone-positive breast cancer, the most common form, across six countries, including the UK, Norway, Sweden, Australia, New Zealand, and Thailand. Patients with low test scores who received only hormone therapy had a 94% recurrence-free survival rate after five years, nearly identical to the 95% rate for those who received both chemotherapy and hormone therapy. The findings are set to be presented at the American Society of Clinical Oncology’s annual meeting in Chicago on Saturday. The trial’s chief investigator, Prof Rob Stein, stated that the results mark a step toward more personalized treatment, sparing many patients the physical and emotional burden of chemotherapy. One participant who skipped chemotherapy described the outcome as feeling “like Christmas.”
Key Facts
- The Optima trial followed more than 4,000 patients with newly diagnosed breast cancer in the UK, Norway, Sweden, Australia, New Zealand, and Thailand.
- The Prosigna test, made by Veracyte, analyzes the activity of 50 genes in tumor tissue to determine the risk of breast cancer returning in the next decade.
- The trial involved 4,429 patients aged 40 or above with hormone-positive breast cancer, which accounts for up to 80% of breast cancer cases globally.
- In the group using the test, patients with a low score received hormone therapy alone; those with a high score received chemotherapy plus hormone therapy.
- Five years after treatment, 95% of low-score patients who had chemotherapy and hormone therapy were alive and free from recurrence, compared with 94% who skipped chemotherapy.
- Prof Rob Stein, chief investigator and professor of breast oncology at UCL, said the results address a “longstanding challenge” in breast cancer care.
- The trial received funding from the National Institute for Health and Care Research (NIHR), Veracyte, and cancer charities.
Conflicting Reports
No conflicting reports identified in the source article.
Still Unclear
No open questions identified in the source article.
Misconceptions
No widespread misconceptions addressed in the source article.
Key Figures
- Prof Rob Stein, chief investigator of the Optima trial and professor of breast oncology at University College London
- Prof Iain MacPherson, co-chief investigator and professor of breast oncology at the University of Glasgow
- Veracyte, the global diagnostics company that makes the Prosigna test
- National Institute for Health and Care Research (NIHR), a funding source
Sources: The Guardian
