A groundbreaking study has revealed that millions of women with breast cancer could avoid chemotherapy thanks to a genomic test that identifies who truly needs the treatment. The randomized international trial, known as Optima, focused on whether the test could pinpoint patients who would not benefit from chemotherapy and allow them to skip it safely.
Game-Changing Results
Experts have hailed the findings as transformative. The five-year cancer-free survival rate was 93.7% in the group that skipped chemotherapy, statistically non-inferior to the 94.9% rate among those who received chemotherapy. This demonstrates that skipping chemotherapy does not compromise outcomes for suitable patients.
Patient Story: Karen Bonham
Karen Bonham, a speech and language therapist from Swansea, Wales, was diagnosed with breast cancer in 2017 after routine screening at age 55. Dreading chemotherapy, she agreed to join the Optima trial after surgery. The Prosigna genomic test analyzed 50 genes in her tumor tissue to assess recurrence risk. Days before starting chemotherapy, she learned she was in the no-chemotherapy group. “Immense relief? Like Christmas?” she recalled. She underwent radiotherapy and hormone therapy instead. Now 64 and retired in Cardiff, she remains cancer-free. “The Optima trial has been integral to this healthy, active retirement,” she said.
How the Test Works
The Prosigna test evaluates the activity of 50 specific genes in tumor tissue to determine molecular subtype and generate a risk score. This helps doctors decide whether chemotherapy is necessary. The trial included 4,429 patients from the UK, Norway, Sweden, Australia, New Zealand, and Thailand.
Implications for Treatment
Not all breast cancer patients can skip chemotherapy; some still require it. However, the results suggest that many women could safely avoid it if the genomic test indicates low risk. The findings will be presented at the American Society of Clinical Oncology’s annual meeting in Chicago.
Bonham hopes the trial will bring positive outcomes to many. “I am mindful of my diagnosis but do not feel defined by it,” she said. “I walk, enjoy yoga, and live well.”
