Survivors on Science: Pass the Hormones Hold The Chemo? Maybe, for some!
Earlier this month we celebrated National Cancer Survivors Day and then learned that some 70% of breast cancer patients may be able to skip chemo - what a way to kick off June!
The TAILORx trial, or more formally Trial Assigning Individualized Options for Treatment (Rx) trial, used a molecular test to examine tumors and assess 21 genes connected with breast cancer recurrence to determine the most appropriate post-operative treatment for women with hormone receptor (HR)-positive, HER2-negative, axillary lymph node–negative breast cancer - a.k.a. the most common form of breast cancer.
The study was comprehensive, enrolling a whopping 10,273 women with this type of breast cancer at more than 1,100 sites in six countries including the United States and Peru.
After the thorough examination, the study found that post-operative treatment that includes chemo and hormone therapy is no more beneficial than treatment including hormone therapy by itself.
To begin the study, patients were given a risk score on a scale of 0–100 for cancer recurrence and based on earlier trials women found within the low risk category (0–10) received only hormone therapy, while those in high-risk (26+) received hormone therapy with chemo.
Ah, but the middle range. It's the middle range - or intermediate risk range - that brought us the bulk of information. These women at risk levels between 11–25, were given a mix of treatments. Some were given hormone therapy and chemo, while some were given only hormone therapy. The objective was to see how the outcomes stacked up and if one way was really any better than the other. Well, it wasn't.
More specifically, it found that chemo may be avoided in roughly 70% of women with HR-positive, HER2-negative, node-negative breast cancer with 45% including women older than 50 with a recurrence score of 11–25, about 16% any age with a recurrence score of 0–10, and about 8% including 50 years old or younger with a recurrence score of 11–15.
Now, for the approximately 30% remaining, chemo may still be considered a go-to for women any age with a recurrence risk of 26–100 (about 17%) and women 50 or younger with a recurrence score of 16–25 (about 14%).
The main take-away is that chemo is not beneficial for most women in the intermediate-risk group (11–25), and we think that's pretty huge!
BUT, there's one exception to note for this range. Researchers further examined premenopausal women as well as those younger than 50 and on the high end of the 16–25 range. Findings here concluded that there still may be a small benefit from chemotherapy in these instances. Still, it remains unclear if the benefit was due to chemo alone, or the effects of chemo-induced menopause which can include endocrine suppression similar to hormone therapy. As a reminder the endocrine system is made up of glands that produce hormones which regulate growth, tissue function, and sleep as well as a host of other things, and endocrine therapy is another term for hormone therapy.
While the study gives us a lot to think about - we encourage all to discuss options with their doctors in detail. Every diagnosis has a difference prognosis - and no one case is the same.
In more exciting news our June survivor, Kimberleigh Dagro (pictured above) is officially cancer-free and feeling like herself again with a spatula in hand, of course.
"I'm fully recovered now and I am back to doing the thing I love most, cooking!"
Kimberleigh and her mom immigrated to the U.S. from Vietnam and were sponsored by a family with roots in Italian, Scottish, and Irish cultures.
This caused for one well-fed girl who knew her way around the kitchen - and the globe.
She shared some sweet (and savory!) memories with us about growing up in a kitchen with a happy mix of cuisines!
“I immediately fell in love with spaghetti and braciole that my American grandfather lovingly made for us each Sunday,” she recalled. “My mom introduced Vietnamese food and our new family not only fell in love with us but her amazing spring rolls as well.”
And Kimberleigh’s still keeping the tradition going.
"Today, almost 40 years later, my kitchen is the perfect example of an East meets West one! I've almost mastered my Mom's spring rolls, my Grandpa's pizzagaina as well as my Grandma's Irish soda bread."
We love this! (And want to come over for dinner ASAP!)
In other celebratory news - happy birthday wishes to last month's survivor Debbie Hernandez and Happy Fathers' Day to all the great dads, grandfathers, and other male guardians that are there for us on our journeys.
Last but not least - we are also celebrating the first day of summer this month with SPF packed and ready to go after a long winter and rainy spring! We see you sun!
Until next time, keep your Eye on Strength!