New genetic test could help women with breast cancer avoid chemotherapy
Published 18 Jul 2016
The EndoPredict test can more accurately predict whether a woman’s cancer will spread around the body than the standard test used on the NHS.
It also can produce results in just a few days compared to fortnight for the current test, Oncotype DX, which has to be posted to the the US.
Both tests provide information about the genetic make-up of a tumour to help predict how cancer might develop over a decade.
This information can be used to identify which patients would be most likely to benefit from treatment with chemotherapy after surgery and those who won't need it, thereby avoiding unnecessary side-effects.
Both tests are for women with oestrogen receptor positive, HER2 negative (ER+/HER2-) disease, which accounts for around two-thirds of all breast cancers.
More than 33,000 women are diagnosed with ER+/HER2- breast cancer each year in the UK.
By identifying those at low risk of their disease spreading, women who would see little benefit from chemotherapy could be spared its gruelling side-effects.
The study – led by researchers at the Institute of Cancer Research in London and the Royal Marsden NHS Foundation Trust in collaboration with Queen Mary University of London, and published in the Journal of the National Cancer Institute – compared the performance of EndoPredict and Oncotype DX.
A woman's risk of her cancer spreading is calculated using the results from the genetic test combined with the size of the tumour and whether the disease has spread to the lymph nodes.
Women are classed as low risk if they have less than a 10 per cent 10 year-long risk of their cancer spreading.
In the study, just 5.8 per cent of all patients identified as low risk by EndoPredict went on to see their cancer spread over ten years compared with 10.1 per cent of patients identified as low risk by Oncotype DX.
Dr Richard Buus, from the Institute of Cancer Research, London, who lead the study, said: "This study showed that a new test is more accurate than the current NHS standard test at detecting women at lowest risk of their breast cancer spreading to other parts of the body in the long-term.
"It could help improve treatment for a large number of women with breast cancer by allowing doctors to better predict which women are least likely to go on to develop secondary cancer – and could therefore be spared from undergoing the chemotherapy often offered early on in treatment to reduce that risk."
Baroness Morgan, the chief executive of Breast Cancer Now, said: "This important study demonstrates the exciting potential of EndoPredict to identify breast cancer patients that will benefit little from chemotherapy.
“This test could give patients and their doctors invaluable reassurance that they may safely be spared chemotherapy's gruelling side-effects.
"Oncotype DX remains a valuable tool for both clinicians and patients. But we need to see the best and most cost-effective technologies made routinely available on the NHS, and this research suggests EndoPredict could be another step forward.
"Based on this strong evidence, we would encourage the National Institute for Health and Care Excellence to consider this technology for routine use on the NHS."
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