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Genetic Test Helps Predict Chemotherapy Success in Breast Cancer

Breast cancer survival can be predicted with a genetic test that indicates which patients will benefit from chemotherapy, according to a study published today.

The study was conducted over 10 years in patients newly diagnosed with invasive breast cancer. The researchers predicted patients’ responsiveness to treatment through a combination of sensitivity to endocrine therapy, chemoresistance and chemosensitivity. The study was published in the Journal of the American Medical Association.

Of the patients predicted to be helped by chemotherapy, the study found a 92 percent survival rate without relapse after three years. The findings will be important for doctors making decisions about whether to prescribe chemotherapy or recommend other treatment, including enrollment in clinical trials, the authors said.

“The treatment a patient receives at initial diagnosis offers the greatest chance for cure,” Lajos Pusztai, a professor at the University of Texas MD Anderson Cancer Center in Houston and an author of the study, said in a statement. “Currently, we’re still not sure who we are curing with chemotherapy and who also could benefit from these novel therapies.”

Last year, more than 207,000 women in the U.S. were diagnosed with breast cancer, and almost 40,000 died from the disease, according to the National Cancer Institute.

‘Predictive Signatures’

The study treated 310 patients with the chemotherapies taxane and anthracycline, followed by endocrine therapy if they were expected to respond to it. Through genetic testing, the researchers then developed “predictive signatures” for response to chemotherapy and applied them to a separate group of 198 patients to determine the test’s accuracy.

“The research builds on a decade of collaborative work in developing a clinically meaningful chemotherapy predictor,” W. Fraser Symmans, a professor in the pathology department at MD Anderson and an author of the study, said in the statement. The results, “if validated in future studies, could guide therapy for about 80 percent of newly diagnosed women with invasive breast cancer who are candidates for chemotherapy.”

The test was developed jointly by researchers at MD Anderson and closely held Nuvera Biosciences Inc. in Woburn, Massachusetts, Symmans said in an e-mail today. The scientists are continuing to “test the test” to ensure its accuracy before it would be used routinely, he said.

“It is possible to predict both response and survival from chemotherapy,” Symmans said. “Careful attention is necessary to do this properly.”

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