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A recent international trial has revealed that a significant number of breast cancer patients could avoid undergoing chemotherapy safely by using a DNA-based test designed to identify those who would genuinely benefit from the treatment. This gene test helps distinguish patients who require chemotherapy from those who can be effectively treated with hormone therapy alone, potentially sparing many from the harsh side effects associated with chemotherapy.
The research, conducted by University College London (UCL) and involving over 4,000 newly diagnosed breast cancer patients aged over 40 across several countries including the UK, Norway, Sweden, Australia, New Zealand, and Thailand, utilized the Prosigna test. This test assesses the activity of 50 specific genes linked to breast cancer progression to calculate the likelihood of cancer recurrence. According to the findings, approximately two-thirds of participants received low-risk scores, allowing them to avoid chemotherapy without compromising their five-year survival rates, which stood at 93.7%, closely comparable to the 94.9% survival rate of patients who did undergo chemotherapy.
Breast cancer treatment typically begins with surgery to remove tumors, followed by chemotherapy to reduce the risk of the cancer returning, especially for those with early-stage disease that has spread to nearby lymph nodes. However, clinicians have expressed concern that chemotherapy may offer limited benefit for patients with the most common form of the disease. UCL estimates that more than 5,000 patients annually through the NHS could potentially forgo chemotherapy based on this test’s results.
One participant in the trial, Karen Bonham from Cardiff, described the trial outcome as an “immense relief” and likened it to “Christmas,” having avoided chemotherapy herself. Instead, she underwent eight years of radiotherapy and hormone therapy. Professor Rob Stein, the trial’s chief investigator at UCL, emphasized that these findings represent a major advancement in personalized cancer treatment. He noted, “The trial has successfully used tumour biology to guide decisions rather than relying solely on traditional clinical features,” adding that this approach not only reduces the physical and emotional toll of chemotherapy on patients but also promotes more efficient use of healthcare resources. Currently, it remains unclear whether the results are applicable to patients under 40, with further research ongoing
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