“This study will have a practice changing impact on the medical community related to prescribing chemotherapy to breast cancer patients. This Oncotype Dx test, can help oncologists identify low risk patients who may safely avoid chemotherapy as well as, the high risk patients who will benefit by chemotherapy. By limiting the use of chemotherapy only to those likely to benefit such personalised treatment has the potential to decrease the overall use of chemotherapy in breast cancer,” remarked Dr Vinay Deshmane, Surgical oncologist at P.D. Hinduja and Breach Candy Hospital, Mumbai.
The TAILORx study, the largest ever breast cancer treatment trial, was published in the New England Journal of Medicine in June. It was supported by the United States of National Cancer Institute (NCI) part of the National Institute of Health, and designed and led by the ECOG-ACRIN Cancer Research Group.
Breast cancer is the most common cancer in women in India and accounts for 27% of all cancers in women. At an incidence rate of 25.8 per 100,000 it is lower than in some developed countries, but the mortality rate (12.7 per 100,000) is comparable to that in western countries. Data on incidence rates of breast cancer has been in the 0.46 to 2.56% range.
The majority of breast cancer patients diagnosed worldwide have hormone-positive, HER2-negative, node-negative cancer. The TAILORx study definitively established that chemotherapy may be spared in about 70% of these patients, including all women older than 50 with ‘Breast Recurrence Score’ results of 0 to 20 and all women aged 50 or younger with ‘Breast Recurrence Score’ of 0 to 15.
Importantly, 30 per cent of early-stage breast cancer patients will derive benefit from chemotherapy, including women of any age with ‘Breast Recurrence Score’ results of 26 to 100, and in women younger than 50, where a modest (2 per cent) benefit from chemotherapy was observed with ‘Breast Recurrence Score’ results of 16 to 20 which gradually grew as scores increased up to and above 25. This important finding reveals a new level of precision of chemotherapy benefit for younger patient that only the Oncotype Dx test can provide.
The TAILORx findings can spare thousands of women from getting toxic chemotherapy treatment that really wouldn’t benefit them. By identify the right patients who can benefit from chemotherapy and sparing chemotherapy and its toxic side effects in those who will not benefit from its treatment, the personalised treatment approach is a breakthrough advancement in the medical fraternity. As the sole commercial representative in India for Genomic Health, we hope to bring changes in the standard of care in India,” said Prasad Vaidya, CEO, Medilinks Inc.
Dr Mandar Nadkarni, Oncosurgeon at Kokilaben Dhirubhai Ambani Hospital, Mumbai, commented, “This is a landmark study in the field of breast cancer management. Results of the study will have a major impact on practising physicians and breast cancer patients. Previously, majority of breast cancer patients all over the world were recommended to receive chemotherapy after surgery with lots of side effects affecting the quality of life of patients. But we were not sure how far chemotherapy is helping improve survival.”
Dr Suresh Advani, renowned Oncologist and Padma Bhushan recipient, concluded, “Today personalisd medicine has allowed us to avoid chemotherapy for certain groups of patients. We can select the people who don’t need chemotherapy and administer it to those who need it.”