Many people with breast cancer can safely avoid chemotherapy with the use of a gene test, potentially sparing them unnecessary side effects without increasing the risk of the cancer returning, a large international clinical trial led by UCL has found.
The OPTIMA trial (Optimal Personalised Treatment of early breast cancer using Multi-parameter Analysis) was designed to reduce the use of unnecessary chemotherapy for people with newly diagnosed breast cancer. It followed more than 4,400 patients across the UK, Norway, Sweden, Australia, New Zealand and Thailand.
Chief Investigator of the OPTIMA trial and Professor of Breast Oncology at the UCL Cancer Institute, Professor Rob Stein said: "OPTIMA addresses a long-standing challenge in breast cancer care: identifying who truly benefits from chemotherapy and who does not. Our findings show that many patients can safely avoid chemotherapy without compromising their outcomes.
This genomic test from Veracyte is called Prosigna, which measures the activity of genes involved in breast cancer growth.
The independent study enrolled 4,429 women and men aged ≥40 years with ER-positive HER2-negative early breast cancer and 0–9 involved axillary lymph nodes.
Of the 4,429 people who took part in the trial, more than two-thirds (68%) had a low Prosigna score.
For this group, the results showed that outcomes were very similar whether chemotherapy was given or not. Five years after treatment:
This suggests that for patients with low Prosigna scores, chemotherapy offers little or no additional benefit, meaning many people could safely avoid it and its side effects.
The OPTIMA trial (Optimal Personalised Treatment of early breast cancer using Multi-parameter Analysis) was designed to reduce the use of unnecessary chemotherapy for people with newly diagnosed breast cancer. It followed more than 4,400 patients across the UK, Norway, Sweden, Australia, New Zealand and Thailand.
Chief Investigator of the OPTIMA trial and Professor of Breast Oncology at the UCL Cancer Institute, Professor Rob Stein said: "OPTIMA addresses a long-standing challenge in breast cancer care: identifying who truly benefits from chemotherapy and who does not. Our findings show that many patients can safely avoid chemotherapy without compromising their outcomes.
This genomic test from Veracyte is called Prosigna, which measures the activity of genes involved in breast cancer growth.
The independent study enrolled 4,429 women and men aged ≥40 years with ER-positive HER2-negative early breast cancer and 0–9 involved axillary lymph nodes.
Of the 4,429 people who took part in the trial, more than two-thirds (68%) had a low Prosigna score.
For this group, the results showed that outcomes were very similar whether chemotherapy was given or not. Five years after treatment:
- 94.8% of those who received chemotherapy alongside hormone therapy were alive and free from breast cancer recurrence
- 93.6% of those treated with hormone therapy alone were also alive and recurrence-free
This suggests that for patients with low Prosigna scores, chemotherapy offers little or no additional benefit, meaning many people could safely avoid it and its side effects.
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