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src="https://web.archive.org/web/20060615013332/http://web.webrelevance.com/msnbc/ads.ashx?pt=health&at=mpt&ct=js&u='+escape(document.location)+'">'); document.write('</scr'+'ipt>'); </script></div></div><div class="CCol w160 fR clrR"></div><div class="mR165"><div><img border="0" src="https://web.archive.org/web/20060615013332im_/http://media.msnbc.msn.com/i/msnbc/Components/Sources/sourceAP.gif" height="20" width="140" vspace="0" hspace="0"><div class="textTimestamp"><div id="udtD">Updated: 9:36 p.m. ET June 12, 2006</div><script language="javascript"> function UpdateTimeStamp(pdt) { var n = document.getElementById("udtD"); if(pdt != '' && n && window.DateTime) { var dt = new DateTime(); pdt = dt.T2D(pdt); if(dt.GetTZ(pdt)) {n.innerHTML = dt.D2S(pdt,((''.toLowerCase()=='false')?false:true));} } } UpdateTimeStamp('632857594125870000'); </script></div></div><p class="textBodyBlack"><span id="byLine"></span>WASHINGTON - Claudia Lowry had a scary decision: Could she safely skip chemotherapy after surgeons removed her breast cancer?</p><p class="textBodyBlack"><span id="byLine"></span>Tens of thousands of women undergo chemo for breast cancer every year when they don’t really need it, but doctors don’t have an easy way to tell who can gamble on skipping the harsh drugs.</p><p class="textBodyBlack"><span id="byLine"></span>A simple gene test now promises to help women like Lowry make that nerve-wracking choice — and a major government study is enrolling more than 10,000 patients around the country to see just how well it does the job.</p><div class="aC"><div class="textSmallGrey w320"><a href="#storyContinued">Story continues below ↓</a><hr noshade size="1"> advertisement <div style="padding:0 10 10 10;"><script>ad_dap(250,300,'&PG=NBC9AZ&AP=1089');</script></div><hr noshade size="1"></div></div><a name="storyContinued"></a><p class="textBodyBlack"><span id="byLine"></span>“Most of the patients are advised to have chemotherapy. Most of the patients are going to do very well without it,” says Dr. Sheila Taube of the National Cancer Institute. “So how can we spare the patients that don’t need it?”</p><p class="textBodyBlack"><span id="byLine"></span>Breast cancer is only the opening salvo. Researchers are furiously developing who-to-treat gene tests for colorectal cancer — particularly for early Stage 2 disease that doctors fear is being under-treated — and other malignancies, too.</p><p class="textBodyBlack"><span id="byLine"></span><b><strong>Gene-tailored therapy<br></strong></b>But if the new breast cancer study pans out, it will mark a big step toward genetically tailored therapy that specialists expect will rapidly replace today’s simplistic guidelines for treating early-stage cancer.</p><p class="textBodyBlack"><span id="byLine"></span>More than 100,000 U.S. women a year are diagnosed with early breast cancer that has a remarkably good prognosis: The tumors are small, haven’t spread, and are hormone-sensitive. The vast majority would survive with surgery, radiation and hormone treatment. Yet guidelines today recommend chemotherapy as well for most of those women to catch the few who need more aggressive help.</p><p class="textBodyBlack"><span id="byLine"></span>In other words, 100 women get chemo, and the risk of harsh, sometimes life-threatening, side effects, to prevent two or three of them from relapsing.</p><p class="textBodyBlack"><span id="byLine"></span><div class="box_brl" style="width:100%;;"><script></script><table width="100%;" cellspacing="0" cellpadding="0" class="boxH_brl"><tr><td width="*" nowrap="true" class="boxHC_brl"><div class="textSmallBold"> Click for related content</div></td></tr></table><table width="100%;" cellspacing="0" cellpadding="0" class="boxB_brl"><tr valign="top"><td class="boxBI_brl"><div class="bigRedLink"><p><a href="/web/20060615013332/http://www.msnbc.msn.com/id/12271549/">Modern chemo changes fate of breast cancer</a></p></div></td></tr></table></div></p><p class="textBodyBlack"><span id="byLine"></span>The Oncotype DX test is supposed to help winnow out some of that overtreatment. It checks a woman’s surgically removed tumor for 21 different genes whose interactions can predict the likelihood of a relapse. Those odds are calculated on a scale from zero to 100.</p><p class="textBodyBlack"><span id="byLine"></span>Having a high “recurrence score” — greater than 30 — makes chemotherapy a good bet: Adding chemo for those patients improves their chances of being cancer-free 10 years later from 61 percent to 88 percent, concluded a manufacturer-funded study that tested tumors stored from hundreds of patients.</p><p class="textBodyBlack"><span id="byLine"></span><table cellpadding="0" cellspacing="0" border="0" width="1%" align=""><tr><td><img border="0" src="https://web.archive.org/web/20060615013332im_/http://msnbcmedia.msn.com/i/msnbc/Components/Art/HEALTH/060612/AP_BreastCancerRelapse(4).gif" height="189" width="450" vspace="0" hspace="0"></td></tr></table></p><p class="textBodyBlack"><span id="byLine"></span>But giving chemo to a low-risk patient — a recurrence score of less than 18 — made no difference, researchers reported in the Journal of Clinical Oncology.</p><p class="textBodyBlack"><span id="byLine"></span>The problem: Women with scores in the middle, between 18 and 30, were in a grey zone; it’s unclear if they benefited from chemo or not.</p><p class="textBodyBlack"><span id="byLine"></span>The new study, funded by the National Cancer Institute, aims to settle how the $3,000 gene test affects treatment decisions.</p><p class="textBodyBlack"><span id="byLine"></span>The main purpose: to determine how to treat the half of patients estimated to fall into that grey zone, with intermediate risk of a relapse. Researchers will randomly assign those women to either get chemotherapy or skip it, and see who fares best. (To double-check the earlier findings, the study also will track low-risk women who skip chemo and high-risk women who get it. )</p><p class="textBodyBlack"><span id="byLine"></span>Results can’t come soon enough, as women like Lowry already struggle to decipher an intermediate score.</p><p class="textBodyBlack"><span id="byLine"></span>A veteran oncology nurse, Lowry knew she didn’t want to undergo the chemo side effects she’d watched patients suffer. But the Kokomo, Ind., woman also had fought back uterine cancer a year earlier. Was she cancer-prone and thus chemo would help?</p><p class="textBodyBlack"><span id="byLine"></span>Oncotype DX didn’t give a clear answer; Lowry’s score was 24, solidly in the grey zone. Still, her doctor used the rating in pouring over previous research to estimate that chemo would only slightly lower her odds of breast cancer returning, validating her decision to skip it.</p><p class="textBodyBlack"><span id="byLine"></span>“It gives us a number, it’s not just a doctor thinking,” Lowry said of the test. “I think it will help a lot of women make up their minds.”</p><div class="textBodyBlack"><i><em>© 2006 The Associated Press. All rights reserved. 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