Genetic Test May Determine if Chemotherapy Needed in Breast Cancer

Category: Cancer

A large clinical trial sponsored by the National Cancer Institute will tell whether women with breast cancer will benefit from chemotherapy prior to initiating the grueling series of treatments. The study, referred to as TAILORx (Trial Assigning Individualized Options for Treatment), will enroll 10,000 women with breast cancer at more than 900 institutions across the United States and Canada.

OncotypeDXTM (a diagnostic test developed by Genomic Health, Inc., in Redwood, Calif., in collaboration with the National Surgical Adjuvant Breast and Bowel Project) identifies which of 21 specific genes are turned on or off in the breast tumor. This allows for calculation of a recurrence score, which tells the likelihood of the cancer returning. Based on this score, researchers will divide women into three groups, those with a score above 25, those between 11-25 and those below 11. The high score group will receive hormonal therapy and chemotherapy, the low score group will receive only hormonal therapy and the middle group will be randomized to receive one or the other of these treatments.

The standard of care is surgery to remove the tumor, plus radiation and hormonal therapy, which is successful in about 80-85% of patients. Adding chemotherapy can further reduce the risk of recurrence in some women. Researchers expect this study will eliminate the uncertainty about using chemotherapy in this middle group.

Posted by Dr. Jennifer Stagg on August 13, 2006 07:27 AM