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New research could shrink chemotherapy growth predictions. Here are 2 ways to prepare.

August 9, 2018

    Two recent studies found evidence that some breast cancer patients may need less chemotherapy. Through genetic testing, the studies identified select groups of patients diagnosed with breast cancer who could either completely forego chemotherapy or have their treatment exposure cut in half.

    The TAILORx study recommends that patients who received ambiguous scores on a diagnostic gene test (the Oncotype DX Breast Cancer Assay) could actually forego chemotherapy. The Persephone study indicates that select patients could see the same benefits of a full treatment cycle, with half the exposure.

    This research means that some breast cancer patients could avoid chemotherapy in the future—and that some could need less of it. Here's how these findings could affect infusion centers, and how planners should prepare.

    Patient groups affected

    These studies are preliminary indications that chemotherapy growth rates for select patients with breast cancer could decrease. If this decrease occurs, it could chip away at strong growth predictions: Currently, Advisory Board projects the overall incidence of cancer will increase by 11% over the next five years.

    The TAILORx findings could change treatment recommendations for breast cancer patients who meet two criteria: They received an intermediate score on the diagnostic test and are HER2-negative. While these patients could be eligible to forego chemotherapy, the findings don't affect these patients' hormone therapy regimen. Additionally, patients under 50 could still be advised to pursue chemotherapy even if they meet these requirements.

    The Persephone study implies that breast cancer patients who are HER2-positive and taking the drug Herceptin (approximately 20% of all breast cancer patients) could receive less chemotherapy.

    Timeline to impact

    It's not clear yet if or how quickly this research will affect care plans. For these studies to make waves, physicians must be willing to change their care planning practices, patients must evolve their expectations regarding treatment, and payers must be willing to see these changes as a high-quality, safe, and cost-effective alternative to the current status quo.

    Planners' next steps

    1. Determine your local impact

      To estimate the potential impact on business, cancer centers should estimate how many of their current and prospective patients could be affected by this new research. Size down national estimations to reflect conditions of your local market.

      Evaluate the estimated volume of future patients within your service area to get an idea of the full potential impact of these new findings. To do so, look at the incidence of relevant cancers using our Cancer Incidence Estimator. For example, to find the number of HER2-postive patients in your service area, use the estimator to get overall breast cancer incidence and then calculate for 20% of this number.

    2. Evaluate genetic testing investments

    3. Develop a plan to identify those breast cancer patients who would be affected by the studies' findings. A robust genetic and genomic testing program can help determine the number of affected patients coming through your centers. In addition, as these studies reach patients, they may become more curious about diagnostic options; having a strong testing program can help you retain and secure these patients.


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