Declining use of chemotherapy for early-stage breast cancer: examining oncologist recommendations
https://www.facingourrisk.org/XRAY/chemotherapy-early-stage-breast-cancer
Full article: https://doi.org/10.1093/jnci/djx239
A new study shows that chemotherapy use for early-stage, node-positive and node-negative breast cancers declined from 2013 to 2015. It also reports that oncologists’ recommendations are influenced to differing degrees by patient preferences and tumor test results, despite unchanging health care guidelines. (8/21/18)
Questions To Ask Your Health Care Provider
- Do you recommend chemotherapy for me?
- Is genomic testing for recurrence risk useful for me?
- How might your recommendation about chemotherapy change given different tumor test results?
- What are the side effects of chemotherapy?
- Will chemotherapy lower my risk for a recurrence?
- Is it possible that I can be treated with endocrine therapy alone and forego chemotherapy?
- Are there any other tests that may help determine the best treatment for me?
Open Clinical Trials
The following studies are enrolling people with early-stage ER-positive, HER2-negative breast cancer.
- NCT03053193: MammaPrint, BluePrint, and Full-genome Data Linked With Clinical Data to Evaluate New Gene EXpression Profiles (FLEX). The FLEX Registry will be a large-scale, population-based, prospective registry. All patients with stage 1-3 breast cancer who receive MammaPrint and BluePrint testing on a primary breast tumor are eligible for this registry.
- NCT05607004: (Z)-Endoxifen for the Treatment of Premenopausal Women With ER+/​HER2- Breast Cancer (EVANGELINE). This study looks at the drug (Z)-endoxifen as a possible treatment for pre-menopausal women with ER+/HER2- breast cancer. (Z)-endoxifen is a type of hormone therapy that blocks the body's natural estrogen from binding to cancer cells.
- NCT04584255: Treating Early-Stage HER2-Negative Breast Cancer with a PARP Inhibitor (Niraparib) and Immunotherapy (Dostarlimab) in People with a BRCA or PALB2 Mutation. This study looks at how well the PARP inhibitor niraparib and the immunotherapy drug dostarlimab treat early-stage breast cancer in people with an inherited BRCA1, BRCA2 or PALB2 mutation.
- NCT03749421: Prosigna Assay on Neoadjuvant Clinical Decision-making in Women With HR+/Her2- Breast Cancer. This study evaluates a genomic analysis called Predictor Analysis of Microarray 50 (PAM50, by Prosigna®) as a tool that guides participants and treating physicians for choose the most personalized pre-operative treatment for breast cancer.
- NCT04567420: DNA-Guided Second Line Adjuvant Therapy For High Residual Risk, Stage II-III, Hormone Receptor Positive, HER2 Negative Breast Cancer. This study monitors people with early-stage, high-risk breast cancer for possible recurrence using a test called circulating tumor DNA (ctDNA). People who test positive for ctDNA but have no other signs of recurrence will receive either the drugs palbociclib combined with fulvestrant or standard-of-care adjuvant hormone therapy.
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NCT04852887: De-Escalation of Breast Radiation Trial for Hormone Sensitive, HER-2 Negative, Oncotype Recurrence Score Less Than or Equal to 18 Breast Cancer (DEBRA). This study evaluates whether breast conservation surgery and endocrine therapy results in a non-inferior rate of invasive or non-invasive ipsilateral breast tumor recurrence (IBTR) compared to breast conservation with breast radiation and endocrine therapy.
Several other clinical trials for patients with early-stage breast cancer can be found here.
About FORCE
FORCE is a national nonprofit organization, established in 1999. Our mission is to improve the lives of individuals and families affected by adult hereditary cancers.