Postmenopausal patients with the most common subtype of breast cancer are currently treated with chemotherapy and hormone therapy, but the former and its side effects can now be avoided. This was pointed out by an international study conducted this week at the world’s largest breast cancer event. New clinical practice may benefit the approximately 5,300 new cases of this type that occur in Spain each year.
Among the various subtypes of Breast cancer, The so-called lumen is the most common, but many women who suffer from this condition will be able to avoid the usual Chemotherapy.
Specifically, postmenopausal patients have the following markers: hormone receptor positive (Relative humidity), epidermal growth factor receptor 2 (HER2) Negative,between 1 and 3 axillary nodules are affected The results are Recurrence score (A score that assesses the risk of recurrence and the likelihood of benefiting from chemotherapy) Equal to or less than 25.
Patients who meet these requirements, on behalf of There are 5,300 new cases in Spain each year At present, they have received chemotherapy and hormone therapy. They will be able to receive treatment without the first treatment, and only the second treatment can achieve the same efficacy and prognosis.In other words, only receive Hormone Therapy And avoid “chemotherapy” and its adverse effects.
This is the research conclusion RxPONDERThe results have been presented at a press conference at the “Press Conference” of the global breast cancer event. San Antonio Breast Cancer SymposiumThis year is actually celebrated from December 8th to 12th.
this is Randomized phase III clinical trial Postmenopausal women whose HR-positive and HER2-negative breast cancer has spread to one to three lymph nodes can safely give up chemotherapy if their tumor tissue genome test recurrence score is less than or equal to 25.
Premenopausal women maintain “chemotherapy”
However, the trial also showed that after about five years of follow-up, premenopausal women with the same disease characteristics can indeed benefit from chemotherapy, so it is recommended to continue chemotherapy in this group.
International clinical trials promoted by U.S. cooperative organizations SWOG Cancer Research Network,in National Cancer Institute (NCI) It has been conducted in 632 centers in nine countries: the United States, Canada, Mexico, Colombia, Ireland, France, Spain, South Korea and Saudi Arabia.
The lead author of the study said: “In clinics around the world, clinicians face the question of how to best treat this common form of breast cancer every day.” Kevin KalinskiSWOG network and researchers from Emory University, Atlanta, USA Result change practice It also proves that postmenopausal women can avoid unnecessary chemotherapy and only receive hormone therapy; this will make clinicians clearer and relieve patients. “
Participation from Spain
In Spain, the clinical trial got GEICAM Breast Cancer Research Group, A total of 792 women participated, accounting for 20% of the total number of patients in the group’s 21 Spanish hospitals participating in the study.
Dr. Dr.” Miguel MartinPresident of GEICAM, “In addition, in the current era marked by the COVID-19 pandemic, it is particularly important for a group of patients to avoid adjuvant chemotherapy. In this period, it is important to reduce hospital visits and reduce immunosuppressive treatments. “.
This The study was conducted in 5,083 patients Women who meet the requirements account for one-third of all women with breast cancer (approximately 8,000 women per year throughout Spain). The standard treatment that has been used for thirty years is chemotherapy (anthracyclines and taxanes) followed by hormone therapy, with an interval of 5 to 10 years.
The test is based on genomic testing Cancer DX, Is a predictive and prognostic tool provided by Exact Sciences (published by Palex Medical in Spain). This tool can quantify the expression of 21 genes in patient tumor tissues, thereby providing indicators of whether chemotherapy is beneficial and recurring cancer. The results Recurrence score.
The Oncotype DX test was performed on the patients participating in the study, 67% of them were postmenopausal and the rest were premenopausal.Fruitful Recurrence score Equal to or less than 25, that is, low (range between 0 and 100), they are randomly assigned to standard treatment with chemotherapy plus hormone therapy or hormone therapy only, and followed up for 5 years”, the main researcher and doctor of the Spanish study Emilio Alba, Head of Medical Oncology Services at the Malaga Region and Virgin de la Victoria University Hospital, member of the Scientific Committee of the GEICAM Group
“The results show that in women who have this tumor after menopause and have between 1 and 3 affected lymph nodes, stopping chemotherapy does not worsen the prognosis. Therefore, this represents approximately 5,300 new cases in Spain each year. In the population of patients, you can avoid chemotherapy”, Dr. Alba emphasized.
However, in addition to hormone therapy, the premenopausal women in the study did benefit from chemotherapy, and their 5-year disease-free survival rate increased by 5%. Among these patients, the rate of chemotherapy plus hormone therapy reached 94.2%, while the rate of receiving only hormone therapy was 89%.
This article also shows The prognosis is good in all patient groups, Although it has affected the lymph nodes. Experts say: “Disease-free survival (that is, patients without tumor recurrence in 5 years) exceeds 90%.”
“The result represents Changes in breast cancer clinical practice Since taxanes were included in treatment, lymph nodes have been positive in the past 25 years. Patients and their quality of life.