Breast cancer treatment usually involves one or more of the following options - surgery, chemotherapy, hormone therapy and radiotherapy. Traditionally, the choice and combination of treatments depends on factors such as the type, size and aggressiveness of the breast cancer, whether it is hormone (oestrogen and progesterone) receptor positive or not, and whether the cancer has spread to other parts of the body. Chemotherapy is often recommended for the treatment of early breast cancer to lower the risk of the breast cancer returning. However, doctors now recognise that chemotherapy benefits some breast cancer patients more than others, and it may be unnecessary altogether for certain patients. The issue now for doctor is identifying which patients are most likely to benefit and which patients are not likely to benefit from chemotherapy.
Promising research has found that a set of 21 genes (units of information contained within DNA) are commonly found to be involved in hormone receptor positive breast cancer. Based on this research a test known as Oncotype DX has been developed to measure the levels of these genes in tumour tissue taken at the time of surgery. The results of the test are entered into a computer which produces a score between 0 – 100, known as a Recurrence Score. This Recurrence Score helps researchers and doctors better estimate a patient’s individual risk of cancer returning in the breast or in other parts of the body over time. Patients with a low score have a lower risk of cancer returning meaning that surgery and 5 years of hormonally therapy may be a suitable treatment plan. While patients with a high score have a higher risk of their cancer returning and therefore may benefit from the inclusion of chemotherapy along with surgery and 5 years of hormonal therapy as part of their treatment plan.
The TAILORx study is designed to look at the most appropriate treatment options for those patients that have an intermediate Recurrence Score. Participants whose tumour produces a low Recurrence Score will receive 5 years of standard hormonal therapy, while participants whose tumour results in a high Recurrence Score will receive standard chemotherapy plus 5 years of standard hormonal therapy. Participants whose tumour produces an intermediate Recurrence Score will be randomly assigned to receive 5 years of standard hormonal therapy or standard chemotherapy plus 5 years of standard hormonal therapy.
The TAILORx study will involve over 11,000 participants from hospitals in the United States of America, Ireland along with over 40 institutions within Australia and New Zealand. |