Chemotherapy Treatment Decisions Guided by Breast Cancer Multigene Test

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Early-stage breast cancer patients can avoid unnecessary chemotherapy by taking a multigene test, according to a study published in the Journal of Clinical Oncology (2010 Jan 11 [Epub ahead of print]).

The study, led by Shelly Lo, MD, an oncologist at Loyola University Health System, included 89 breast cancer patients who received a multigene test. Using the multigene test, which is designed to examine 21 genes from a tumor sample, researchers were able to determine how active the genes were and predict the likelihood of cancer recurrence.

The results revealed that the multigene test prompted doctors to change their treatment recommendations in 31.5% of cases, while 27% of patients changed their treatment decisions based on the results from the test. In most such cases, the change by both doctors and patients was to avoid chemotherapy.

“This is the first study to show that results from this test simultaneously impact decisions by physicians as well as patients,” Dr Lo noted.

According to the press release announcing the study, doctors said that the test increased their confidence in their treatment recommendations in 76% of cases, and in 97% of cases doctors said they would order the test again. Furthermore, after receiving the test results, patients reported that they were significantly less conflicted about their decision and felt significantly less anxiety about their decision.

“This test of patients' own breast cancer provides us with greater certainty of who derives benefit from chemotherapy and who can safely avoid it,” concluded senior author Kathy Albain, MD, professor in the Department of Medicine, Division of Hematology/Oncology, Stritch School of Medicine.
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