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Precision medicine has breast cancer in its sights

Breast cancer survival continues to improve and, thanks to personalised treatment tests like Prosigna, fewer patients unnecessarily receive chemotherapy.


Achieving almost 80 per cent of breast cancer patients alive and disease-free 10 years after their diagnosis is an ‘astonishing achievement’ in the treatment of the disease. This according to Robert Stein, professor of breast oncology at University College London (UCL).

Almost 80% of breast cancer patients are now disease-free 10 years after their diagnosis.

Stein attributes improved outcomes to a range of factors, including greater public awareness and the introduction of drugs to prevent recurrence as a routine part of treatment.

‘Developments have proved hugely successful,’ says Stein. ‘The aim now is to make breast cancer treatment much more personalised.’

Precision medicine

Prosigna (also known as PAM50) is a valuable diagnostic tool that accredited laboratories use to analyse an individual’s genes in order to determine the best treatment options for them based on their biological make-up.

Not every patient benefits from chemotherapy, and the side effects can be gruelling.

A patient is given chemotherapy based on factors such as how aggressive their cancer is and whether it has spread to the lymph nodes. But not every breast cancer patient benefits from receiving chemotherapy, and the side effects of this treatment can be gruelling. Some patients recieve far more benefit from hormone therapies, meaning chemo could be completely avoided without reducing patient survival rates.

The type of precision medicine offered by tests like Prosigna gives doctors more accurate information on treatment suitability for the individual than that of traditional microscope diagnostics, and what Stein calls, ‘an historic, one-size-fits-all approach to treatment.’

A pioneering trial called Optima, the largest ever UK chemotherapy trial, is currently helping medical experts tailor their patients’ treatment using Prosigna.

Testing in the UK will also reduce the length of time it takes for patients  to get results.

Stein, who is overseeing the trial, says it could eventually mean bypassing chemotherapy in favour of hormone treatment alone, for as many as two thirds of cases of the common hormone-sensitive breast cancer type.

What’s more, the Prosigna test can be performed in UK laboratories, so precious tissue samples don’t need to be sent abroad for analysis (as is currently the case). Testing in the UK will also reduce the length of time it takes for patients  to get results.

Research trials improve outcomes

Dr Adrienne Morgan heads up the Independent Cancer Patients’ Voice charity and is a patient advocate for the OPTIMA trial . Diagnosed with breast cancer in 2005, Morgan says she ‘lost a year of her life’ to chemo, which for her to proved ineffective and still triggers side effects today.

Morgan’s cancer, which has now spread to her bones, wonders what the outcome of the disease might have been had she been given hormone treatment immediately.

‘Trials are the only way treatment improves,’ she says.

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