Over 3.5 million women survived breast cancer in 2016, according to the American Cancer Society. The emerging era of personalized cancer therapy could knock this number out of the park. And that’s good news.
Personalized cancer treatment targets a person’s genetic makeup and the cellular environment surrounding a tumor. If there is enough information about a person’s genetic composition, oncologists can recommend more effective therapies to prevent or attack cancer.
A groundbreaking discovery
On June 3, 2018, the National Cancer Institute (NCI) released new results from the Trial Assigning Individualized Options for Treatment (Rx), also known as TAILORx trial. The groundbreaking TAILORx trial provided new evidence that chemo after surgery offers no benefit for 70 percent of women with the most common type of breast cancer — hormone receptor (HR)-positive, HER2-negative, axillary lymph node–negative breast cancer.
The study is scheduled for publication in the New England Journal of Medicine.
What is the TAILORx Trial?
Back in 2015, the TAILORx analysis was published. It showed that a gene expression test was powerful enough to identify women who do not need chemotherapy. According to the analysis, women with a low risk of recurrence could skip chemo without any consequences. But to do this, they had to be identified first.
The new TAILORx 2018 study was designed to research the efficacy of hormone therapy alone versus hormone therapy plus chemotherapy for breast cancer treatment in women with a mid-range score of 11-25 on the oncotype DX Breast Recurrence Score Test, a 21-gene expression test.
The trial was conducted across countries, including the United States, Australia, Canada, Ireland, New Zealand, and Peru. The study enrolled 10,273 women with early-stage, HR-positive, HER2-negative, axillary lymph node-negative breast cancer.
What did the 2018 TAILORx Trial Find?
- The 21-gene expression test assessed the risk of a woman’s cancer recurrence using a scale of 0-100 for cancer recurrence.
- Women in the low-risk range (0-10) received hormone therapy alone; women in the high-risk range (26 and above) received hormone therapy plus chemotherapy; however, women in the mid-risk range (11-25) were randomly assigned to either hormone therapy alone or hormone therapy plus chemotherapy.
- For those in the mid-risk range (11-25), the results for women who were assigned to either group were similar, showing that there are no benefits to adding chemotherapy to hormone therapy.
What does this mean for women with early breast cancer?
This study is a landmark in oncology research. According to Jeffrey Abrams, M.D, associate director of the National Cancer Institute (NCI), “These findings, showing no benefit from receiving chemotherapy plus hormone therapy for most patients in this intermediate-risk group, will go a long way to support oncologists and patients in decisions about the best course of treatment.”
Based on evidence from the study, if you belong to the groups below (about 70 percent of women with HR-positive, HER2-negative, node-negative breast cancer), you should discuss the potential avoidance of chemo with your physician:
- older than 50 and with a recurrence score of 11-25 (45 percent)
- any age with a recurrence score of 0-10 (16 percent)
- 50 years old or younger with a recurrence score of 11-15 (8 percent)
The Future of Oncology
The TAILORx trial is a groundbreaking study in oncology, but there are other similar studies that are already changing the way we think about personalized cancer therapies. As organizations such as the NCI continue to invest resources in this field, we may witness more revealing studies on the horizon.