Millions of women with breast cancer could avoid chemotherapy thanks to a groundbreaking genomic test, according to trial results presented at the American Society of Clinical Oncology's annual meeting in Chicago. The Optima trial, led by University College London, involved over 4,000 patients across six countries, including the UK, and found that those with a low score on the Prosigna test could be treated safely with hormone therapy alone.
The test analyses the activity of 50 genes in tumour tissue to determine the risk of cancer returning within a decade. Patients with a low score who skipped chemotherapy had a 94% recurrence-free survival rate after five years, compared to 95% for those who received chemotherapy, indicating little additional benefit from the toxic treatment.
Chemotherapy's side-effects, such as hair loss, nausea, fatigue, infertility and cognitive impairment, can be life-changing. The trial's chief investigator, Professor Rob Stein, said the results mark a significant step toward personalised medicine, allowing many patients to avoid the physical and emotional burden of chemotherapy without compromising outcomes.
One participant described the relief of skipping chemotherapy as 'like Christmas'. Nine years after diagnosis, she remains healthy and active. The findings could transform healthcare guidelines worldwide, offering a more efficient use of resources for health systems.
