PEORIA — When the results of a landmark breast cancer study were published in the New England Journal of Medicine early this month, the staff at Illinois CancerCare were not surprised at the results — they had helped gather information for the study.
About 100 central Illinois women participated in the largest breast cancer treatment trial ever conducted. More than 10,000 participants in six countries helped researchers determine new treatment protocols. Their findings will affect a huge number of women diagnosed with breast cancer going forward.
“It is a landmark study that has helped shape the way we not only treat, but also how we approach breast cancer patients,” said Dr. Madhuri Bajaj, who oversees the research department at Illinois CancerCare. “Now we can really give them a full answer, the most complete answer possible, as to what is the risk of their breast cancer coming back after surgery, and what treatment would be most ideal, and have them be able to weigh the risks and benefits of treatment without the grey area that’s been persistent for about the past decade.”
The study, called the TAILORx trial, examined patients with hormone-driven cancer that had not spread to the lymph nodes and did not contain a protein called HER2. The conclusion researchers reached is one many cancer patients will be glad to hear — in most cases patients can skip chemotherapy.
For about 10 years, oncologists have been using a genetic test called Oncotype DX Breast Cancer Assay on patients with early stage breast cancer. Performed on tumor samples gathered during surgery, the test determines if chemotherapy would help. When results came back either high or low, doctors had a clear roadmap on how to proceed. But the middle results — found in about 70 percent of patients — left many questions unanswered, said Dr. Panjak Kumar in an informational video released by Illinois CancerCare.
“This is not a small group of patients. In the U.S. there are about 70-80,000 patients per year who are falling into this category," he said.
The study results have given doctors a better idea of how those patients should be treated.
“Seventy percent of those patients didn’t show any additional benefit with the addition of chemotherapy,” said Bajaj. “They could be treated just like the low-risk breast cancer patients.”
In the other 30 percent of patients, the majority of them younger than 50 years old, chemotherapy might have slight value, but further study will be done on this subset of patients, said Bajaj.
Since the study was published June 3, doctors at Illinois CancerCare have been using the new treatment protocols, Bajaj said.
“We discuss it with the patient and tell them the value of the test (the Oncotype DX Breast Cancer Assay). It is part of the national guidelines to order it, and insurance companies cover it. Once we get those results, if they are at intermediate risk, we now know what to tell them, based on what their score is, and what their age is.”
While chemotherapy is a valuable tool in the fight against cancer, it has many side effects. Being able to use it less often helps doctors improve the quality of life for their patients, said Bajaj.
“These results help to make sure we are not giving chemotherapy in excess of what’s absolutely needed for that patient. We want to first do no harm,” she said. “That is the oath we took, and I think that is what we want to make sure we keep. So these kind of trials help us be able to do that.”
The TAILORx trial is one of many Illinois CancerCare has participated in since it was founded in the late '70s, Bajaj said. It was because of the group's proven track record in research that it was chosen to participate in this landmark study.
“We do some really important research here,” said Bajaj. “The depth of clinical trial research we have here ranges from studies that are extremely patient specific and tailored to an individual, to studies that are applicable to masses of oncology patients.”
Doing research helps Illinois CancerCare provide cutting-edge treatment to its patients.
“If there is any apprehension or misconception that you may not get access to world-class cancer care in your hometown, this is a testament to the fact that that’s not true,” she said. “Because we are so well-versed in research, and so connected to the research giants of the world running these studies, if we don’t have something that is ideal for you, we would know who would, and we would make every effort to make sure that you get where you need to be.”
Leslie Renken can be reached at 686-3250 or firstname.lastname@example.org. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.