As the morning went on there was a second report that is directly applicable to the clinic. The science has shown us over the past decade that there are different kinds of breast cancer that behave differently and respond to different treatments. The question is always which are which. The Oncotype DX test is one attempt to figure this out. They have shown in the past that they can discriminate between node-negative estrogen-receptor positive women with a high, medium and low rate of recurrence, and that the women with the low score do well with tamoxifen and get little benefit from chemotherapy. Last year they extended this to the node-positive patient showing that the biology of the tumor is more important that its stage.  Today they went a step further looking at women who are estrogen positive and node positive and were treated with either tamoxifen or anastrozole (an aromatase inhibitor). This was the largest study of this test and it came out with flying colors showing again that even in women with positive nodes they can distinguish the high risk from the low risk and identify who needs hormonal treatments and who needs chemotherapy.



One way to think about this is that it is like antibiotics. If you have an infection caused by a certain bacteria, it is important to take the antibiotic that the bacteria is sensitive to. If you have a really bad infection you don’t switch to a stronger drug but one that the bacteria are resistant to.



Oncotype Dx is an example of these new tests that enable us to figure out which treatment is likely to be the best for your ER-positive tumor, regardless of whether your nodes are positive.



Other tests are being explored for ER-negative breast cancer and, in fact, some of yesterday's data suggested there may soon be a way to figure out which HER2/neu drug (Tykerb or Herceptin) would match better for your tumor. The era of personalized medicine is getting closer!


For further information from this meeting, go to www.dslrf.org.