Being able to avoid chemotherapy would be a blessing for thousands of women with breast cancer.
The majority of women with the most common type of early-stage breast cancer can safely skip chemotherapy after surgery, according to a highly anticipated new report.
The breast cancer epicemic can not be reversed without considering women's exposure to chemical cocktails throughout their lives, argued Professor Andreas Kortenkamp of the University of London, presenting new scientific evidence to the European Parliament.
Professor Alan Melcher, from the Institute of Cancer Research in London, said: "This treatment represents a remarkable success in terms of translating our basic biological understanding of how the immune system responds to cancer into a real treatment of real benefit".
The study was centred on a 21-gene test performed on tumours that has been available for breast cancer patients since the early 2000s.
In cancers such as those of the breast, colon and prostate, scientists have long detected that "there is some immune reaction", Mackall said.
Those women should carefully discuss their options with their oncologist, said Brawley, because they would likely be candidates for the more aggressive, dual therapies.
The study is limited in some ways.
The study was funded by the National Cancer Institute, some foundations and proceeds from the US breast cancer postage stamp.
It found that Merck pharmaceutical's drug Keytruda (pembrolizumab) - which famously helped former United States president Jimmy Carter stave off advanced melanoma that had spread to his brain - helped lung cancer patients live four to eight months longer than chemo.
However, there is still uncertainty about the benefit of chemotherapy for most patients who have a midrange score, they specified. For women aged under 50 with scores of 16-25, there was some benefit in getting chemotherapy, but for those aged over 50 with scores under 25, or those aged under 50 and scores below 16, there was nothing to be gained from going through the draining process. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is created to block the cancer-spurring effects of hormones.
Tens of thousands of women each year in North America alone fall into the categories where chemotherapy is unnecessary, accounting for 70 percent of those with the most common forms of breast cancer.
A high recurrence score, above 25, means chemo is advised to ward off a recurrence, while a low score, below 10, means it is not. After years of follow-up, the data showed that most patients who did not get chemotherapy fared as well as those who did. "It was all gone", she said. The Oncotype DX RS ranges from 0 to 100 and can predict chemotherapy benefit when the score is high, meaning higher than either 26 or 31. By finding, isolating and multiplying the tiny subset of immune cells that are still in the fight, then demonstrating their ability to vanquish a patient's tumors, Rosenberg's group has shown that "the cells are there", Mackall said.
When Perkins received her experimental therapy just before Christmas 2014, she said she sensed the optimism of the National Cancer Institute researchers who devised this new approach to immunotherapy.
Still, he acknowledged that most patients with this form of advanced cancer will die within months, and "we need to do a lot more work".
Breast Cancer Now also called for Nice to reflect the findings in its guidance.