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MINDACT Trial - Sparing patients an aggressive treatment they would not benefit from

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The first results of the MINDACT trial, using the MammaPrint® test, have just been presented and give hope to many women with early-stage breast cancer: in future, it is possible that up to 46% of patients who would have received chemotherapy in the past can be spared from this treatment and its side-effects.

Many patients with early-stage breast cancer receive chemotherapy after surgery to reduce the risk of breast cancer recurrence. The MINDACT trial was designed to identify those patients with early-stage breast cancer (with 0 to 3 involved lymph nodes) who can be safely spared from aggressive treatment. MINDACT has demonstrated that the analysis of genes in the cancer cells can provide important information about the biology of a patient’s tumour beyond the clinical-pathological tests traditionally used to make treatment decisions. 

Use of the MammaPrint® test has shown that up to 46% of the patients who in the past would have been considered at high risk of breast cancer relapse and would therefore receive chemotherapy can now safely avoid such treatment.

Dr. Martine Piccart, MD, PhD, co-founder and chair of the Breast International Group (BIG) and head of the Medicine Department at the Jules Bordet Institute in Brussels, Belgium, was a co-principal investigator of the trial. MINDACT can be qualified as a landmark study she said, “Not only has the MINDACT trial the potential to change the way doctors treat patients with breast cancer, it has also created a huge resource for future research, because research using the participants’ tumour samples, blood samples, and clinical outcomes data could allow us to gain a substantially better understanding of the biology of breast cancer.” 

The MINDACT trial is managed and sponsored by the European Organisation of Research and Treatment of Cancer (EORTC) as part of an extensive and complex partnership in collaboration with BIG, Agendia (MammaPrint®) and many other academic and commercial partners, as well as Europa Donna, the European Breast Cancer Coalition.

MINDACT press release

AACR Press Release, April 18

Breast cancer and chemotherapy

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Breast cancer is the most common cancer amongst women worldwide, affecting 1 in 8 women in developed countries during their lifetime. Nowadays breast cancer can be cured if diagnosed and treated at an early stage. Chemotherapy is frequently administered to patients with breast cancer to eliminate any cancer cells that might be circulating in the body, with the aim of ensuring that the cancer will not return. However, chemotherapy does have unpleasant and sometimes potentially dangerous side-effects, such as cardiac problems and, in rare cases, secondary cancers. It can also be expensive, thereby increasing the financial pressures on public healthcare systems when not used selectively in the patients who will most likely benefit. 

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Node negative breast cancer is a cancer that has not spread to the surrounding lymph nodes and therefore has a lower risk of recurrence. Scientists have also demonstrated that breast cancer which has spread to 1 to 3 lymph nodes may behave like node negative breast cancer. Patients with either node negative cancer or with a cancer that involves 1-3 lymph nodes are often prescribed chemotherapy, although physicians have generally believed that approximately 15% of them do not require such treatment.   

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The MINDACT trial set out to show that a considerable proportion of patients with node-negative or 1 to 3 lymph node positive early breast cancer can be safely spared adjuvant chemotherapy based on the biology of their disease – and this has now been proven with the highest level of scientific evidence.