The work is part of an approach to cancer treatment called de-escalation: an effort to individualize treatment to a specific disease subtype, achieving the same results with less treatment and fewer interventions.
Some women with breast cancer may forego chemotherapy if genetic testing determines it will not help and other drugs are available, sparing them both short-term side effects and long-term complications. long term ; some lung cancer patients may also forgo chemotherapy. Breast-conserving lumpectomy rather than mastectomy is also part of de-escalation, as is giving up surgery altogether, as in this trial. In a separate clinical trial, Dr. Kuerer is also examining whether radiation is still needed.
“What I really like about the study is that it takes the next step and asks a bold question: how do we use all the advances we’ve made in cancer therapy that’s more tailored and more and convert them into fewer and fewer procedures a patient has to undergo?” said Karen Knudsen, CEO of the American Cancer Society.
“Asking if we can reduce surgery is a reasonable next consideration for the future of cancer care.”
Pamela Romero, who participated in the trial and was deemed eligible not to have surgery, had traveled from her home in New Iberia, Louisiana, to MD Anderson in 2018 to get a second opinion shortly after having discovered a small bump near his sternum. His tumor was HER2-positive and the size of a grape.
(A HER2-positive tumor contains cells with receptors for human epidermal growth factor 2. Only women with HER2-positive tumors and triple-negative tumors, which contain cells that lack receptors that respond to estrogen, progesterone and human epidermal growth factor 2, were included in the trial.)
“The doctor asked, ‘How do you feel about the surgery?’ and I said, ‘I’m scared to death,'” Ms. Romero, 66, recalled in an interview. “I said, ‘If I can get rid of the cancer without surgery, I’m all for it. “”
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