Clinical calculator could spare breast cancer patients unnecessary hormone therapy for five years

New research confirms that an algorithm, called CTS5, can accurately identify patients with a significantly lower risk of subsequent reoccurrence of their bad cancer. In doing so, this means that some patients may need to undergo hormone treatment for five years instead of ten, which, according to the researchers, could have a considerable impact, psychologically and physically.

The vast majority of bad cancer patients will be prescribed at least five years of hormone therapy after standard treatment (surgery, chemotherapy and / or radiotherapy) to reduce the risk of recurrence of cancer.

After five years, oncologists and patients must decide whether the extension of this type of treatment is useful and appropriate. Hormone therapy can have significant side effects for some patients, including weak bones, blood clots, exacerbation of menopausal symptoms, and the psychological burden of ongoing treatment.

CTS5 was published in 2018 in a study confirming its prognostic value. However, it had not yet been tested in a "real world", that is, not on selected patients in the clinical trial, and on pre- and postmenopausal women. The CTS5 test is the only clinical prognostic tool available to determine late recurrence of distance.

In this new study, researchers from the Royal Marsden NHS Foundation Trust and Queen Mary University in London used CTS5 to badyze data from 2428 patients not participating in the trial at the Royal Marsden. The findings will be presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

The study confirmed that CTS5 was effective in predicting relapse of bad cancer after 5 years. The CTS5 test clbadified a group of 2428 bad cancer patients into three risk groups: high, medium and low. It is important to note that 41% of postmenopausal women – 700 patients – had a very low risk of having their bad cancer recur five to ten years after their initial five-year treatment with hormone therapy. The researchers concluded that this risk is so low. this would not justify the extension of endocrine treatment to ten years. Unlike previously published tests on CTS5, this new badysis took into account pre-menopausal as well as post-postpatient patients.

The lead author, Dr. Juliet Richman, Clinical Research Scientist at the Royal Marsden NHS Foundation Trust, said, "Our badysis shows that this tool works well in a diverse population of bad cancer patients. clinical context, we must know that CTS5 will be accurate for a variety of women.

"We can establish that people at very low risk of occurrence of recurrent bad cancer and stating that it would be extremely unlikely to benefit from an extension of hormonal therapy over the past five years." In doing so, they can avoid potential side effects, both physical and psychological – of continuous treatment. "

Dr. Ivana Sestak, senior author at Queen Mary University in London, said, "It is extremely important to determine which women are at high risk of late recurrence in order to continue hormone therapy." In addition to predicting recurrence The first time we were able to show that CTS5 also predicts a late recurrence in premenopausal women, by testing the model with actual hospital data of women treated for early-stage bad cancer, we were able to demonstrate that Use of our calculator was feasible in the real world.

"Our online calculator is available free of charge to oncologists around the world to determine the risk of late recurrence for their patients, is very easy to use and only requires information that is readily available to clinicians. whether the tool could be used by research nurses, which frees up time for clinicians. "

Further research is needed to confirm that patients who continue hormone therapy after a high CTS5 score benefit from this extension.

Provided by
The Royal Marsden NHS Foundation Trust