Many Women With Common Type Of Breast Cancer Can Forgo Chemotherapy

The Associated Press: Many Breast Cancer Patients Can Skip Chemo, Big Study Finds
The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs. "The impact is tremendous," said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don't need treatment beyond surgery and hormone therapy, he said. The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test. (Marchione, 6/3)

The New York Times: Good News For Women With Breast Cancer: Many Don’t Need Chemo
Many women with early-stage breast cancer who would receive chemotherapy under current standards do not actually need it, according to a major international study that is expected to quickly change medical treatment. ... The study found that gene tests on tumor samples were able to identify women who could safely skip chemotherapy and take only a drug that blocks the hormone estrogen or stops the body from making it. The hormone-blocking drug tamoxifen and related medicines, called endocrine therapy, have become an essential part of treatment for most women because they lower the risks of recurrence, new breast tumors and death from the disease. (Grady, 6/3)

The Washington Post: Most Women With A Common Type Of Early-Stage Breast Cancer Can Skip Chemo, A New Report Finds
The cancer in question is driven by hormones, has not spread to the lymph nodes and does not contain a protein called HER2. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is designed to block the cancer-spurring effects of hormones. Otis Brawley, chief medical and scientific officer of the American Cancer Society, called the trial a good example of “precision medicine” and said it would save many women from unneeded chemotherapy. (McGinley, 6/3)

NPR: Breast Cancer Genomic Test Can Rule Out Need For Chemo
In the U.S., the most recent data shows around 135,000 new cases yearly of the specific breast cancer studied, says Dr. Joseph Sparano, an oncologist at Montefiore Medical Center, a professor of medicine at the Albert Einstein College of Medicine and the lead author of the study. Twenty-five percent of those patients won't qualify for chemotherapy because of age or medical problems. Out of the 100,000 or so patients who could take the gene test to help make a decision about chemotherapy, he says at least two-thirds fall into the middle range that can benefit from the study findings. (Watson, 6/3)

The Wall Street Journal: Doctors Suggest Less Chemo, Surgery For Some Cancer Treatments
The studies are part of a growing movement among cancer doctors and researchers to de-escalate treatments for certain tumor types, as drugs become increasingly expensive. The average U.S. monthly price of oncology drugs more than doubled to $15,535 in 2015 from $7,103 in 2006, according to a May report in the Journal of Oncology Practice. Overall U.S. spending on cancer drugs doubled from 2012 to 2017, to nearly $50 billion, according to IQVIA Institute for Human Data Science. (Loftus, 6/3)

In other oncology news —

Stat: Cancer Patients Want Immunotherapy Even When Evidence Is Lacking
Immunotherapy is a source of great hope in cancer care. It has rescued some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds. But these therapies are also creating a vexing dilemma for doctors: Their patients, citing television ads and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer. (Ross, 6/4)

Stat: Grail Cancer Liquid Biopsy Shows 'Proof Of Principle,' But Challenges Remain
Along way to go, but getting there — that’s the verdict on the highly anticipated data Grail released Saturday about its liquid biopsy for cancer. The Illumina spinoff is almost as well known for its executive departures and ability to raise buckets of money as for its out-of-the-park goal: detecting tumors super-early, when even cancers with a horrible prognosis might be treatable, by analyzing DNA that has escaped its cells and is floating in the blood. (Begley, 6/2)

Stat: ASCO Talk Highlights Risk For Bristol, Nektar With Experimental Cancer Drug
On Saturday night, the controversy around the experimental cancer immunotherapy drug NKTR-214 ratcheted higher following a new data presentation at the American Society of Clinical Oncology annual meeting. Nektar Therapeutics and Bristol-Myers Squibb, the owners of NKTR-214, are undertaking a hugely expensive program to run nearly two dozen clinical trials spanning 20 indications across nine types of solid tumors. Phase 3 studies in melanoma, kidney cancer, and urothelial cancer are starting soon. (Feuerstein, 6/3)

The Associated Press: Blacks Fare Surprisingly Well In Prostate Cancer Research
Black men with advanced prostate cancer fared surprisingly well in two new studies that challenge current thinking about racial disparities in the disease. Blacks are more likely to get prostate cancer and to die from it than whites, but the new research suggests getting access to the same treatment may help balance the odds — even if it doesn't greatly extend life after cancer has spread. Given the same standard treatments, blacks with advanced disease may do even better than whites, the studies suggest. (Tanner, 6/1)