LATEST INNOVATIONS!
The tailorx study..... about 70% of early stage
breast cancer patients can avoid the agony
of chemotherapy
T
he
Trial
Assigning
Individualized Options for
Treatment (Rx) study is the
largest ever breast cancer treatment
trial that was supported by the United
States National Cancer Institute (NCI)
and designed and led by the ECOG-
ACRIN Cancer Research Group and
was published in the New England
Journal of Medicine in June. 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 from six major cancer
registries of India show that the annual
percentage increase in the incidence of
breast cancer has been in the 0.46 to
2.56% range. The trial enrolled 10,273
women with breast cancer from 6
countries across the globe. It used the
Oncotype DX Breast Recurrence Score®
(BRS®) test that assesses the expression
of 21 genes associated with breast
cancer recurrence to assign women
with early-stage, HR-positive, HER2-
negative, axillary lymph node–negative
breast cancer to the most appropriate
and effective post-operative treatment.
TAILORx participants with BRS®results
from 0 to 10 were treated with
endocrine therapy alone based on the
prior results from the NSABP B-20
study, which showed no opportunity
for chemotherapy benefit. TAILORx
participants with BRS results from 26
to 100 were treated with chemotherapy
plus endocrine therapy based on the
prior results from the NSABP B-20
study, which showed an absolute
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Volume 4 | Issue 1 | January-March 2019
benefit of chemotherapy greater than
20%. To more precisely define the
effect of chemotherapy for women
considered to be at intermediate risk
for recurrence, 6,711 women with
Oncotype DX BRS® results of 11 to 25,
the primary study group in TAILORx,
were randomized to receive endocrine
therapy with or without chemotherapy.
These randomized patients comprised
two-thirds of all patients enrolled in
TAILORx and were followed by the
investigators for approximately nine
years on average.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 BRS®
results of 0 to 25 and all women age
50 or younger with BRS® results of 0
to 15. Importantly, 30 percent of early-
stage breast cancer patients will derive
benefit from chemotherapy, including
women of any age with BRS® results of
26 to 100, and in women younger than
50, where a modest (2 percent) benefit
from chemotherapy was observed with
BRS® 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 patients 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. The medical
fraternity will be highly benefited with
this breakthrough finding wherein they
will be able to 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 only drawback
of the Oncotype DX test is its cost
which is around Rs. 2.75 lacs in India.
allowed us to avoid chemotherapy for
certain group of patients. We can select
the people who don’t need chemo and
administer it to only those who need it.”
Source: www.healthtechnology.com