Test to predict likelihood of breast cancer relapse could help thousands

In In The News by Barbara Jacoby

By: Sophie Borland

From: dailymail.co.uk

Thousands of women could benefit from a new test for breast cancer which predicts how likely it is that the illness will return.

Those found to be at high risk would be urged to carry on taking preventative drugs for five years and beyond after they have had surgery.

Currently, all women with the most common form of breast cancer – oestrogen positive – are advised to take hormone drugs such as Tamoxifen for up to five years after surgery to remove tumours.

But researchers from the Royal Marsden Hospital in London have claimed that a test already available on the NHS could be used in a slightly different way to identify high risk women who would benefit from taking the drugs for longer.

This is the Oncotype DX test, which analyses the genes in a sample of tumour removed after surgery to predict the aggressiveness of the cancer.

It is currently used to assess whether women need chemotherapy after surgery and has been available since 2013.

However, it costs between £2,000 and £2,500, and many hospitals do not use it because it is so expensive.

Researchers say the test could be easily modified to spot other genetic traits, identifying women whose lives could be saved if they took the drugs for longer after surgery and chemotherapy.

In a study involving more than a thousand women, they found that those with a high oestrogen marker identified by the test were at twice as much risk of the cancer returning after five years.

Professor Mitch Dowsett, head of the department of biochemistry at the Royal Marsden, said: ‘Our study, of more than 1,300 women with oestrogen positive breast cancer, indicates that women with high levels of the oestrogen receptor might benefit from extended treatment with hormone therapy – which usually stops after five years.

‘The Oncotype DX test, which we used in our study and has become available on the NHS, could be used to detect which women are in this group.’

Professor Dowsett, who also specialises in hormonal medicine at the Institute of Cancer Research, added: ‘While we know that some women benefit from extended treatment, it is also clear that many suffer side-effects. We urgently need to bring new ways of identifying which women would benefit from extended treatment into routine use as quickly as possible.’

Dr Matthew Lam, senior research officer for the charity Breast Cancer Now, said: ‘Oncotype DX is already being used by doctors to help make the best treatment decision for each patient, so there’s no reason why this new use for the test couldn’t quickly and easily be integrated into clinical practice in the future.’

Around 50,000 women develop breast cancer each year in the UK, of whom 70 per cent have the oestrogen positive form and would benefit from using the test.

But other experts said larger trials were needed to check the method was effective before it was routinely offered to patients.

Dr Kat Arney, Cancer Research UK’s science information manager, said: ‘This study suggests a way to identify which women might benefit from taking hormone therapy for breast cancer over a longer period of time.

‘It’s a great idea, but needs to be tested in clinical trials to prove whether it really can benefit patients by helping them to avoid unnecessary drug treatment.’

She added that the findings are a ‘further step away from the one-size-fits-all approach’ to cancer treatment.

‘Just as no two people are exactly the same, no two breast cancers are identical,’ she said. ‘Research like this takes us towards a future with a tailored approach, with the right personal treatment.’