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New genomic test spares patients chemotherapy with no adverse effect on survival
Date:3/22/2012

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In addition to the results of the test, the researchers also used the riskprediction tool Adjuvant!Online (AOL) in order to obtain a prognosis. AOL estimations were used retrospectively for comparison in the study because it is the most widely-used risk calculation tool. In around 35% of the patients the results of the two tests were discordant. The AOL risk estimates were not used at the time of treatment decision-making, which was based on the result of the Mammaprint test, Dutch national guidelines and patients' and doctors' preferences.

In the group classified as low risk by the Mammaprint test only 15% of the 219 patients received adjuvant chemotherapy as opposed to 81% (169/208) in the group classified as high risk by the Mammaprint test. The first group had a five-year distant disease-free survival (DDFS) rate of 96% compared with 90% in the high risk group. In the groups where the Mammaprint and AOL results were discordant, where the genomic test predicted a low risk and AOL a high risk, 43% of patients received endocrine therapy and 24% chemotherapy. There was a 98% DDFS in this group. Where AOL predicted a low risk but Mammaprint a high one, 78% received endocrine therapy and 57% chemotherapy. The DDFS in this group was 95%.

"It is encouraging to be able to tell patients that we believe they will have just as good a chance of avoiding the recurrence of cancer by not having adjuvant chemotherapy as by having it," says Dr. Linn. "Many patients dread the idea of chemotherapy, and by avoiding it they can substantially reduce the stress involved in having cancer, as well as improve their overall quality of life."

Initially the test had to be carried out on fresh frozen tumour tissue, which involved complicated and expensive logistics. But since January, technical advances have meant that it is now possible to use formalin-fixed, paraffin-embedded tissue, the standard way to store tumour tissue, and this will
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Contact: Mary Rice
mary.rice@riceconseil.eu
ECCO-the European CanCer Organisation
Source:Eurekalert

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