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Sparing women chemotherapy

Postmenopausal women with a certain common type of breast cancer, and whose cancer falls within specific parameters for lymph node spread and risk of recurrence, receive no extra benefits from chemotherapy when it is added to hormone therapy, according to results from a recent clinical trial.

These findings may save tens of thousands of postmenopausal women each year the time, money, pain and harmful side effects that come with chemotherapy infusions.

The study, known as RxPONDER, provides long-term evidence that postmenopausal women with HR-positive, HER2-negative breast cancer that has spread to between one and three lymph nodes can safely forgo chemotherapy if their recurrence risk is relatively low.

However, the trial also showed that premenopausal women with the same disease characteristics do benefit from chemotherapy. 

“Every day in clinics around the world, physicians wrestle with the question of how to best treat women with this common form of breast cancer,” said lead author Kevin Kalinsky, M.D., director of the Glenn Family Breast Center at Emory University. “These results are practice-changing and demonstrate that postmenopausal women can be spared unnecessary chemotherapy and receive only hormone therapy. This should bring more clarity to physicians and some relief for patients.”

The RxPONDER team screened nearly 9,400 women with HR-positive, HER2-negative breast cancer and one to three positive lymph nodes to identify those with recurrence scores of 25 or less. (Scores range from 0 to 100, with 25 and below rated in the low or intermediate risk range.)

About 5,100 patients were randomly assigned to receive either hormone therapy alone or hormone therapy plus several months of intravenous chemotherapy. Two-thirds of the women in the trial were postmenopausal, and all were monitored for a median of five years. 

RxPONDER will follow patients for a total of 15 years, so more data from the study will be forthcoming. 

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