Breast cancer: how to limit therapeutic escalation

Sparing patients intensive treatments because they would not benefit from them, even though they would risk suffering their toxic effects. Oncologists are beginning to address this sensitive issue, as evidenced by two recent studies. For example, a clinical trial, the results of which were published on August 4 in a leading medical journal, The Lancet , conducted on elderly women with hormone-dependent breast cancers – the most common breast tumor, accounting for 70% of them, particularly from the age of 70.

"Does it make sense to insist on giving chemotherapy to all patients over 70 who have undergone surgery for hormone-dependent breast cancer, in addition to their hormone therapy?" This is the question posed by Professor Etienne Brain, an oncologist at the Curie Institute in Saint-Cloud (Hauts-de-Seine), in light of the results of this study that he coordinated.

Promoted by the Unicancer network and conducted in 84 clinical centers in France and Belgium, this trial, named "Aster 70s," recruited 1,969 patients with such cancer, aged 70 to 95 (median age of 75.1 years), between April 2012 and April 2016. All had undergone surgery for their tumor. For each of them, the tumor tissue was screened for a prognostic biomarker, the "genomic grade." Developed by Ipsogen, this test analyzes four genes involved in tumor cell proliferation; this genomic signature then provides an indicator of the cancer's aggressiveness.

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