Breast cancer recurrence gene test gets NHS go-ahead

A genetic test to estimate the
chance of breast cancer recurrence after surgery is set to become more widely
available on the NHS.

From April 2015, hospitals will
be able to sign up to an access program enabling them to provide the Oncotype DX
Breast Cancer Assay to eligible
breast cancer patients after surgery. The test aims to help decide whether or
not to prescribe chemotherapy to breast cancer patients after surgery by trying
to better predict the chances of distant recurrence of the cancer.

Although recommended by the National Institute for Health
and Care Excellence (NICE) in 2013 for use in patients with
certain types of early stage breast cancer (reported in BioNews 724), the test
has not been widely used so far due to its cost of between £2,000 and £2,500
per patient, says the Daily Mail.

The access programme allows NHS hospitals
to provide genetic testing to some patients by implementing the NICE diagnostic
guidance, explains the company behind the test, Genomic Health. Its chief operating officer and chief financial officer, Brad Cole, said: 'In the past few years, more than 3,500 women
in the UK have used the Oncotype DX test, and we believe the latest agreement
will facilitate quick adoption throughout England.'

In the UK around 50,000 women are diagnosed with breast cancer each
year. Once a tumour is surgically removed, a course of chemotherapy and
drugs may be prescribed to minimise the chances of recurrence.

However, chemotherapy has a number of unpleasant side effects. Research has shown that fewer than ten
percent of patients with early-stage breast cancer actually benefit from
chemotherapy, with current methods for making treatment decisions often
resulting in over-treatment. This can cause both decreased quality of life for
the patient and increased costs for the NHS.

Professor Kefah Mokbel, of the
London Breast Institute, told the Daily Mail that up to 25 percent of
breast cancer patients will be eligible for the test. Genomic Health states that almost one
third of treatment recommendations for early-stage breast cancer patients
changed after the using the Oncotype DX test.

The test looks
at the expression of 21 genes in breast tissue removed during surgery. It then
indicates how likely recurrence will be and if the patient will benefit from
chemotherapy, giving patients a score on a scale of 1-100.

This score, along with more traditional methods of assessing the chances
of cancer recurrence, can help doctors to decide whether or not chemotherapy
will be beneficial to the patient.

Dr Emma Pennery, clinical director from Breast Cancer Care charity, told
the Daily Mail the test would be invaluable. She said, 'This test could enable
[patients] to avoid the brutal side-effects of chemotherapy without
compromising their survival.'