基因檢測(cè)顯示更多的乳腺癌患者可以跳過(guò)化療

The majority of women with a common form of breast cancer may be able to skip chemotherapy after surgery, based on their score on a genetic test, researchers said Sunday.

研究人員周日稱，大多數(shù)女性患乳腺癌的常見(jiàn)形式可能會(huì)在手術(shù)后跳過(guò)化療，基于他們?cè)诨驒z測(cè)中的得分。

As many as 65,000 women in the United States alone could be impacted by the study, described as the largest breast cancer trial to date, released at the American Society of Clinical Oncology annual meeting in Chicago.

據(jù)美國(guó)臨床腫瘤學(xué)會(huì)年會(huì)在芝加哥舉行的年度會(huì)議上公布，迄今為止美國(guó)最大的乳腺癌試驗(yàn)稱，僅美國(guó)就有65,000名婦女受到這項(xiàng)研究的影響。

Until now, women have faced a great deal of uncertainty about whether to add chemo to hormone therapy after a diagnosis with hormone-receptor positive, HER-2 negative breast cancer when found at an early stage before it has spread to the lymph nodes.

到目前為止，在激素受體陽(yáng)性，HER-2陰性乳腺癌診斷后，如果在早期階段發(fā)現(xiàn)HER-2陰性乳腺癌已經(jīng)擴(kuò)散到淋巴結(jié)之前，她們是否需要加入化療來(lái)激素治療尚存在很大的不確定性。

With results of this ground-breaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer, said co-author Kathy Albain, an oncologist at Loyola Medicine.

“由于這項(xiàng)開(kāi)創(chuàng)性研究的結(jié)果，我們現(xiàn)在可以安全地避免大約70%被診斷為乳腺癌最常見(jiàn)形式的患者進(jìn)行化療，”Loyola Medicine的腫瘤學(xué)家Kathy Albain說(shuō)道。

For countless women and their doctors, the days of uncertainty are over.

“對(duì)于無(wú)數(shù)女性和他們的醫(yī)生來(lái)說(shuō)，不確定性的時(shí)代已經(jīng)結(jié)束。”

A 21-gene test called Oncotype Dx that has been around since 2004 has helped guide some decisions, post-surgery.

一項(xiàng)名為Oncotype Dx的21基因檢測(cè)自2004年以來(lái)一直在幫助指導(dǎo)手術(shù)后的一些決定。

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.

高于25的高復(fù)發(fā)評(píng)分意味著建議化療避免復(fù)發(fā)，而低于10分的低分則意味著不復(fù)發(fā)。

The current study involved more than 10,000 women and focused on those whose scores were in the middle range, from 11 to 25.

目前的研究涉及超過(guò)10,000名女性，并關(guān)注那些分?jǐn)?shù)在11-25的中間范圍內(nèi)的女性。

Patients, aged 18 to 75, were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone.

18至75歲的患者被隨機(jī)分配接受化療，然后單獨(dú)接受激素治療或激素治療。

Then, researchers studied the outcomes, including whether or not cancer recurred, and overall survival.

然后，研究人員研究結(jié)果，包括癌癥是否復(fù)發(fā)以及總體生存。

For the entire study population with gene test scores between 11 and 25 -- and especially among women aged 50 to 75 -- there was no significant difference between the chemotherapy and no chemotherapy groups, said the findings, published in the New England Journal of Medicine.

“對(duì)于基因檢測(cè)得分在11-25之間的整個(gè)研究人群 - 尤其是50-75歲的女性 - 在化療組和無(wú)化療組之間沒(méi)有顯著差異，”研究結(jié)果發(fā)表在“新英格蘭雜志”上醫(yī)學(xué)。

The results show that all women over 50 with a recurrence score of 0 to 25 can be spared chemotherapy and its toxic side effects.

結(jié)果顯示，50歲以上的復(fù)發(fā)評(píng)分為0至25分的所有女性都可以免除化療及其毒副作用。

For women under 50 with a score of 0 to 15, chemo could be skipped.

對(duì)于50歲以下的0到15分的女性，可以跳過(guò)化療。

However, among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group, so in those cases doctors may urge patients to consider a chemo regimen.

然而，在16至25分的年輕女性中，化療組的結(jié)果略好，因此在這些情況下，醫(yī)生可能會(huì)敦促患者考慮化療方案。

The results "should have a huge impact on doctors and patients," Albain said.

結(jié)果“應(yīng)該對(duì)醫(yī)生和患者產(chǎn)生巨大的影響，”Albain說(shuō)。

We are de-escalating toxic therapy.

“我們正在逐步升級(jí)毒性治療。”

According to first author Joseph Sparano of Montefiore Medical Center in Bronx, New York, "any woman with early stage breast cancer 75 or younger should have the test and discuss the results" with her doctor.

根據(jù)紐約布朗克斯Montefiore醫(yī)學(xué)中心的第一作者約瑟夫斯帕拉諾的說(shuō)法，“任何75歲或以下的早期乳腺癌患者都應(yīng)該和她的醫(yī)生一起進(jìn)行檢查并討論結(jié)果。

Breast cancer is the leading cause of cancer death in women worldwide, causing some 1.7 million new cases annually and over half a million deaths.

乳腺癌是全球女性癌癥死亡的主要原因，每年造成約170萬(wàn)新病例和超過(guò)50萬(wàn)人死亡。

The study′s primary funding came from the US National Institutes of Health.

該研究的主要資金來(lái)自美國(guó)國(guó)立衛(wèi)生研究院。