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Hold the Chemo

TAILORx trial researchers say that most women with early stage breast cancer who receive a low recurrence risk score on Genomic Health's Oncotype DX test do well on hormonal therapy alone and are disease-free after five years, as GenomeWeb has reported.

As the team writes in the New England Journal of Medicine this week, 1,626 women in their study had a low recurrence score of 0 to 10 and were assigned to receive endocrine therapy alone without chemotherapy. After five years, they found that the rate of invasive disease–free survival in this cohort was 93.8 percent and the rate of overall survival was 98.0 percent.

"We knew these patients were going to do well, but we didn't dream they would do this well," lead author Joseph Sparano from the Montefiore Medical Center and Albert Einstein College of Medicine tells the Wall Street Journal.

"This is a group of patients that we are likely over-treating with chemotherapy," adds the University of Texas MD Anderson Cancer Center's Jennifer Litton, who was not involved in the study. "Using this test we can spare these patients from chemotherapy."

But, she says the trickier question is whether to treat women with intermediate-risk scores with both hormonal therapy and chemotherapy or with hormonal therapy alone, an issue the trial also examining.