Reduce the risk of recurrence once the tumor eliminated is the goal of chemotherapy is called “adjuvant” data to some women being treated for breast cancer
But these drugs cause side effects sometimes heavy (nausea, vomiting, hair loss, fatigue acute cognitive disorders) are not useful to all patients.
The challenge is to identify those who will benefit from it because they present a risk of relapse which may be fatal, while sparing other treatment superfluous and harmful. ” ALSO READ – breast Cancer – what is it? The cancer scientists in france have to do this from 2016, in addition to the clinical examinations and biological by conventional genomic analyses, which determine from a sample of tumor the level of risk of re-offending. These predictive tests, however, should not be supported by the health Insurance. In an opinion published Monday, 11 February, the High Authority of health judge their repayment “premature”. “None of the scientific studies that we have examined can validate at this stage in their clinical utility,” said Dr. Cedric Carbonneil, head of the department that carried out this evaluation. In addition, several of these research have been conducted in the United States, where the chemotherapy regimens are much more common, which makes their results non-transferable. ” “We recommend conducting a prospective, controlled study based on an exhaustive collection of data,” Dr. . Carbonneil The HAS recognize the “potential significance” of these genomic signatures as a tool to aid in the therapeutic decision, but judge “is essential to continue the research clinic”. “We recommend conducting a prospective, controlled study based on an exhaustive collection of data,” says Dr.
” ALSO READ – breast Cancer: unfavourable opinion for the reimbursement of predictive tests According to the notice published on Monday, the genomic signature should in future be reserved for patients at intermediate risk of recurrence. It is of women with localized cancer of small size (between 1 and 5 cm), grade 2, with little or no lymph nodes. That is, a population of 5 to 10% of the patients (from 2000 to 4 000 women per year) for which an uncertainty remains on the best interest of the chemotherapy. The tests (*) are currently funded by the ministry of Health to hospitals that request them, by virtue of a derogation reserved for medical innovations. The genomic signature should in future be reserved for patients at intermediate risk for recurrence of Their provision, three years ago, had raised great hope among patients.
President of the French Society of predictive medicine and personalized, professor Pascal Pujol regrets the notice of the HAS. “It is incomprehensible, then, that several OECD countries have opened up access to these tests and their support, following the recommendations of recent international,” he says. Noting the “heterogeneity” in the prescription of chemotherapy adjuvant, HAS advanced the absence of national guidelines clarifying the indications of this treatment in breast cancer infiltrating.
It therefore recommends the development by the national cancer Institute repository of good practices. (*) Mammaprint, Oncolype Dx,and Prosigna and Endopredict .