Tuesday, June 18, 2024

Breast Cancer Treatment Advances: NICE Supports Tumor Profiling to Minimize Unnecessary Chemotherapy

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NICE (National Institute for Health and Care Excellence) has taken a significant step forward in breast cancer treatment by endorsing tumor profiling tests, which could lead to a reduction in unnecessary chemotherapy for patients with early-stage breast cancer. These tests, which evaluate the genetic characteristics of breast cancer tumors, are set to transform how post-surgery treatments are planned, potentially sparing many patients from the adverse effects associated with chemotherapy. By providing detailed insights into the molecular structure of tumors, these tests allow for a more personalized approach to treatment, tailoring therapies to the specific needs of each patient.

This precision medicine approach could significantly improve treatment outcomes by identifying patients who would benefit most from additional therapies beyond surgery. Moreover, the use of tumor profiling can help avoid the one-size-fits-all treatment model, which often leads to over-treatment and unnecessary side effects for patients unlikely to benefit from chemotherapy. The implementation of these profiling tests represents a move towards more evidence-based, targeted cancer care, which is likely to enhance patient quality of life and overall survival rates.

NICE Backs Tumor Profiling to Refine Chemotherapy in Early Breast Cancer

The independent diagnostic advisory committee of NICE has reviewed evidence supporting the efficacy of these profiling tests. Specifically, the tests are recommended for men and postmenopausal women who have oestrogen receptor (ER) or progesterone receptor (PR)-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer with 1 to 3 positive lymph nodes. The tests—EndoPredict, Prosigna, and Oncotype DX—quickly provide a risk profile for breast cancer recurrence, integrating this with other clinical data like tumor size to enhance recurrence risk predictions.

Typically, the decision to administer chemotherapy follows surgery for breast cancers that have spread to a few lymph nodes. These decisions are influenced by the specific cancer traits, the potential for disease recurrence, and patient preferences. The additional insights from tumor profiling can refine these decisions, potentially leading many to forego unnecessary chemotherapy, thereby avoiding its debilitating side effects.

Mark Chapman, interim director of the Health Technologies Programme at NICE, emphasized the importance of these tests in helping patients make informed treatment choices. He highlighted that understanding the likelihood of cancer spread is a major advancement for patient care. The committee was moved by patient testimonies about the emotional and psychological challenges of deciding on chemotherapy, stressing that while chemotherapy remains crucial for some, others can now avoid its harsh effects with more confidence.

Breast Cancer

NICE Expands Use of Tumor Profiling in Breast Cancer Treatment

The recommendation for these three tests underlines NICE’s commitment to ensuring that NHS patients receive the best possible care through innovative and cost-effective health solutions. These tests, already advised for use in certain early-stage breast cancer patients, are now recommended for broader application, including for patients with slightly more advanced disease.

Breast cancer remains the most prevalent cancer in the UK, with substantial diagnoses annually. This recommendation by NICE is poised to change the landscape of breast cancer treatment, offering hope and improved quality of life for many. By expanding the use of tumor profiling tests, NICE aims to refine therapeutic decisions and improve the outcomes for thousands of patients, reflecting a paradigm shift in managing early breast cancer.


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Resource: National Institute for Health and Care Excellence, May 10, 2024

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