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Prognostic test helps select breast cancer patients avoid chemotherapy

Pune: An advanced prognostic test is helping select breast cancer patients avoid chemotherapy, especially at a time when the scare of Covid-19 has confined many high-risk individuals to their homes.

It helped doctors a great deal in the case of Prabhakar, in his 60s, who was diagnosed with a malignant tumour (breast cancer) at an early stage.

“After surgically removing the breast lump, we did a risk assessment by using the advanced CanAssistBreast prognostic test. We found that Prabhakar was in a low-risk category and could avoid chemotherapy. We have put him on hormonal therapy and he is responding well,” said Ruby Hall Clinic’s oncosurgeon Amol Dumbre-Patil said.

In India, the majority of early-stage breast cancer patients get treated with chemotherapy. Most of them have to bear the side-effects of the treatment in addition to the monetary drain. Breast cancer, medical experts said, is no longer a one-size-fits-all disease.

Decades of research has shown that breast cancer has clearly distinguishable subtypes that need to be treated differently, they said.

The prognostic test is used to predict a patient’s likelihood of developing a disease. “In the case of prognostic tests for early-stage breast cancer, the test predicts the patient’s likelihood of developing metastasis (spread of cancer cells). If the risk is very low, the patient does not need to be given chemotherapy as this would amount to overtreatment,” Dumbre-Patil said.

The test is performed in the nationally accredited central laboratory-based in Bangalore. Once the patient knows they have breast cancer, they undergo a biopsy and then surgery to remove the tumour. The tumour is then fixed in formalin-fixed paraffin-embedded (FFPE) or wax blocks. The patient’s FFPE goes for testing, which helps the oncologist decide on the course of treatment.

“The same FFPE blocks, if required, can be used for prognostic testing. The patient does not have to undergo any additional procedure for the test,” said Manjiri Bakre, founder and CEO, OncoStem Diagnostics.

OncoStem Diagnostics is the company that developed and launched the test in India in November 2016.

The indigenous diagnostic tool has significantly brought down the cost as imported tests are beyond reach for many in India. Confirming it, Pune-based oncosurgeon Pranjali Gadgil said, “I have been using internationally available tests in this space. These imported tests, however, are cost-prohibitive.”

Close to 1,000 patients across India have benefited from the test so far. Many patients have also received reimbursement from their health insurance companies for the test, thereby, increasing the access. “As with all other prognostic tests, it has to be prescribed by an oncologist and the results have to be interpreted by the oncologist,” Bakre said.

The experts said the test produces a risk score ranging from 0-100.

“If the patient has a score of 15.5 or less, s/he falls into low-risk. And if his/her score is 15.6 upwards, the individual falls in high-risk category,” a medical expert said, adding that the report with risk score is issued within 10 working days.

Clinical studies involving close to 2,000 patients have found the test reliable. The data is on par with what Western tests have demonstrated in their clinical trials and these studies have been published in various international peer-reviewed journals, the experts said. They also said that it was based on immunohistochemistry, whcih is a method for detecting antigens or proteins in cells of a tissue section.

News Courtesy: ET Healthworld


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