Some women with breast cancer do not need chemotherapy

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UNITED STATES (VOP TODAY NEWS) — Breast cancer has become much more common in the early stages, when the chances of a cure are still high. Now doctors and patients are increasingly interested in minimizing the toxicity of treatment, of course, while maintaining efficiency.

This requires the most differentiated approach to each situation.

For example, estrogen-negative, HER2-positive breast cancer usually includes: removing most of the tumor, combining it with antibodies to reduce the ability of the HER2 gene to support the growth of cancer cells, and, finally, chemotherapy to directly kill cancer cells.

But it seems that in some cases chemotherapy can be excluded from the equation. Researchers at the John Hopkins Cancer Center have identified a biomarker to predict when immunotherapy is sufficient.

This biomarker is detected using a PET scan and is associated with the rate of absorption of radio-modified glucose by cancer cells.

A study on the identification of a diagnostic biomarker involved 88 women with ER-negative, HER2-positive breast cancer. PET scans were performed before therapy and 15 days after the first cycle of pertuzumab and trastuzumab.

Pertuzumab and Trastuzumab are monoclonal antibodies that specifically target specific proteins in HER2-positive cancer cells and are widely used to treat HER2-positive breast cancers.

Usually they are used in combination with chemotherapeutic drugs that poison cells and give the corresponding side effects. But in this experiment, immunotherapy was started without chemotherapy and watched the progress of treatment.

Researchers tried to assess whether early changes detected by PET scans in the early stages of immunotherapy can help determine whose tumor will completely disappear after treatment targeting HER2.

After two weeks of treatment with antibodies, scientists have found that they can indeed predict whether a patient will respond to treatment directed at HER2 without chemotherapy.

The best marker was the change in glucose consumption by cancer cells two weeks after the start of treatment, as well as the very significance of this consumption after two weeks of immunotherapy.

High levels of glucose uptake after two weeks indicated that the antibodies probably would not cope with the tumor alone and need support in the form of chemotherapy. Conversely, low levels, as well as their reduction, promised that chemotherapy would be “a third extra”, and patients could be spared from toxic effects.


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