A large trial has shown that women with type A luminal carcinoma can only undergo conservative surgery and hormone therapy: even without radiation, more than 97% of the participants had no relapses
Nine out of ten women in Italy are alive five years after being diagnosed with breast cancer and for years, specialists have been looking for new treatments with two very specific objectives: firstly, to develop effective strategies for those more aggressive forms and for those metastatic patients who still need innovative therapies today, given that the tools available are not revealed. sufficiently valid in their case; on the other hand, check how to achieve healing with the bare minimum of side effects. On both fronts, at the annual congress ofAmerican society of clinical oncology (Asco), recently concluded in Chicago, important progress has been announced. Among these, the results of the “Lumina” study, which involved over 500 Canadian patients with a luminal type A breast cancer to see if they could be spared radiotherapy, they are able to change current treatment strategies.
Avoid radiotherapy
Of the approx 55 thousand diagnoses of breast cancer annually in Italyabout 70% of the luminal type, that is, it expresses estrogen receptors but not the HER2 protein (the so-called ER positive / HER2 negative) – clarifies Giuseppe Curigliano, director of the Division for the development of new drugs and innovative therapies of the European Institute of Oncology in Milan -. After the surgery, the treatments foresee radiotherapy and, in addition, the use of hormone therapy in cases considered to be at low risk of relapse (luminal A) or the addition of adjuvant chemotherapy, i.e. after surgery, to hormone therapy in the presence of a high risk (luminal B). Luminals A are neoplasms that have an excellent prognosis and experts have long been waiting to be able to understand if it was possible to omit radiotherapy. The results of this extensive experimentation give us the answer: we can reduce the intensity of the treatment as the data clearly demonstrate that avoiding radiation does not impact disease-free survival of women. Especially those in menopause, therefore, will only be able to receive hormonal therapy.
I study
The trial participants were all over the age of 55, with negative lymph nodes and a type of luminal carcinoma A less than two centimeters in diameter, excised with conservative surgery. They have also all been subjected to a specific blood test that verifies the presence of a biomarker (Ki67) associated with tumor proliferation, found in only 13.25% or less of these patients’ cancer cells. Based on the low aggressiveness of this neoplasm subtype, the Canadian researchers proposed to the patients hormone therapy alone, without radiotherapy, and then checked them every six months for the next five years or more. The results of the “Lumina” study indicate that women with luminal carcinoma A and low Ki67 levels can avoid radiation treatment and its unwanted consequences (such as chronic fatigue, lymphedema, cardiac toxicity), because the risk of a relapse is very low – he explains Lucia Del Mastro, coordinator of the Breast Unit of the IRCCS San Martino di Genova -. In fact, after an average of 5 years from diagnosis, 97.3% were alive without having had any relapse, while the probability of a local recurrence (in the same breast) was only 2.3% and that of a relapse on the breast opposite of 1.9%.
June 21, 2022 (change June 21, 2022 | 19:11)
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