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How does chemo score affect treatment?

Page last modified on: November 20, 2008
Question from JeanMc: I know Genomics is conducting a clinical trial investigating lowering the lower end of the score for chemo to 11. I had a score of 15 July/05. If it becomes apparent that the lower range should be below the current score of 17, how will that affect the treatment for those of us with scores between 11 and 17 in the past, if at all?
Answers —Jennifer Griggs, M.D., M.P.H.: The genomic profile test that you refer to generates a score between 0 and 100 that appears to correspond to the risk of recurrence and, possibly, the benefit of chemotherapy. The patients for whom we use this test, sometimes called Oncotype Dx, are people who have negative lymph nodes (no cancer in the lymph nodes) and estrogen-receptor-positive breast cancer. These are the same patients in whom we recommend hormonal therapy. The test can help us decide who would benefit from chemotherapy as well. The study that you are referring to is being run by several clinical trial groups throughout the country. Our goal is to figure out whether or not chemotherapy helps women who have the in-between (intermediate) score. In other words, some women have a "high" score, and in those women we recommend chemotherapy. Some women have a "low" score, and in those women we often recommend hormonal therapy only. The in-between group, again called the intermediate scores, are less clear in terms of what to do. So the study is enrolling women who have an intermediate score and then randomly assigning them (like the flip of a coin) to either receive chemotherapy or hormonal therapy only.

For women to be able to go on this clinical study, they need to have a score that the study group has called intermediate and you are right that what is called the intermediate group for the study is different from the published clinical trials. It's understandable that this leads to some uncertainty on the part of a woman who has what we previously called a low score and still call a low score, but who could be considered eligible for this study in women with an intermediate risk score. We will not know the answer to your question until the results of this study are available. In the meantime, your score was interpreted according to the published clinical studies.
Marisa Weiss, M.D., president and founder: This ongoing study will require several years before meaningful results are available.

On Wednesday, December 20, 2006, our Ask-the-Expert Online Conference was called Updates from the San Antonio Breast Cancer Symposium 2006. Jennifer Griggs, M.D., M.P.H. and moderator Marisa Weiss, M.D. answered your questions about the newest research on breast cancer treatment, side effects, risk of recurrence, and more.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Jennifer Griggs, M.D., M.P.H.Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, with a a special interest in cancer survivorship, patient-physician communication, and quality of care for women with breast cancer.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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