Adding Chemo Does Not Has Influence In Breast Cancer Treatment

A new study finds some early stage breast cancer survivors will benefit just as well from endocrine therapy without the need for chemotherapy to prevent recurrence

Judy Perkins had hormone receptor-positive breast cancer that had spread to her liver and other organs and had exhausted all other treatment options, including several rounds of chemotherapy, and none had stopped the disease progressing.

"It is not only a benefit to patients in not undergoing unnecessary toxic treatment, but it provides a level of confidence and it reduces the distress in how they make a decision", says Dr. Stephen Chia, Medical Oncologist in BC Cancer's Vancouver centre and Head of the Province's Breast Tumor group.

In an ongoing phase 2 clinical trial, the investigators are developing a form of ACT that uses tumour-infiltrating lymphocytes (TILs) that specifically target tumour cell mutations to see if they can shrink tumours in patients with these common epithelial cancers.

"All cancers have mutations, and that's what we're attacking with this immunotherapy", he said.

In a lab, Rosenberg's team grew those few immune cells into billions, then injected them into Perkins' bloodstream. Such malignancies account for the vast majority of the 600,000 cancer deaths that will occur in the United States this year. "The very mutations causing the cancer will be the Achilles' heel".

The cancer in question is driven by hormones, has not spread to the lymph nodes and doesn't contain a protein called HER2. There are still times when chemotherapy is appropriate for patients with Stage 1 breast cancer and each patient's specific case should be reviewed by a medical oncologist. Rosenberg believes the army of immune cells are still at work. In the test after 42 weeks of treatment, Judy was completely free from the cancerous cells. The doctors had given Judy three months to live.

It's hard to find a person who hasn't been affected by cancer in some way, and for those of us who have had the sickness or lost someone to the sickness, it seems that cancer research and treatment moves at a slower-than-molasses pace.

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Testing solved a big problem in figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston.

When they again began growing, she received another batch of cells - more aggressively targeted to her mutation - the following year.

The patient with advanced colon cancer whom Rosenberg's team treated in 2015 is Celine Ryan of MI. She said she felt changes right away.

Perkins hopes she's cured - a word she is nearly afraid to utter - but knows that the cancer "could come back tomorrow". After surgery, one group got endocrine therapy only, while the other was treated with endocrine therapy plus chemotherapy.

While chemotherapy is being dropped for some cases, it's being increased for more aggressive cancers.

"She may have lost her life", her husband, Scott Satterfield, said recently, "but I hope someone else will gain from her trial".

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