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Jun 01, 2026
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Genomic Test Could Spare Millions of Breast Cancer Patients From Chemotherapy

AI Summary
A large international trial shows a new genomic test can safely identify breast‑cancer patients who can skip chemotherapy, preserving quality of life without compromising survival. The findings could reshape treatment guidelines and reduce healthcare costs worldwide.

Scientists from University College London and partners have proved that a 50‑gene genomic test can reliably pinpoint hormone‑positive breast‑cancer patients who do not need chemotherapy, potentially sparing millions from toxic side‑effects.

Optima Trial Demonstrates Genomic Test Can Identify Low‑Risk Patients

The Optima trial enrolled 4,429 women aged 40+ across the UK, Norway, Sweden, Australia, New Zealand and Thailand. Participants were split into a standard‑care arm (chemotherapy + hormone therapy) and a test‑guided arm where treatment was decided by the genomic score.

Trial Numbers Reveal Near‑Identical Survival Rates

Five‑year outcomes were strikingly similar:

  • 95% of patients receiving chemotherapy remained alive and recurrence‑free.
  • 94% of patients who skipped chemotherapy (low‑score group) were also alive and recurrence‑free.
  • The test classified patients using a score derived from the activity of 50 tumour genes, produced by Veracyte's Prosigna assay.

These figures indicate that for low‑score patients, chemotherapy adds little or no survival benefit.

Potential Shift in Breast Cancer Treatment Guidelines

Prof Rob Stein, chief investigator, says the results “address a longstanding challenge” by moving decision‑making from clinical features to tumour biology. Health systems could see reduced drug costs, fewer hospital visits, and a dramatic drop in chemotherapy‑related toxicity.

Future Adoption and Healthcare Savings

With funding from the NIHR, Veracyte and cancer charities, the study paves the way for rapid guideline updates at bodies like ASCO and NICE. Wider implementation could translate into billions of dollars saved globally and improve quality of life for countless patients. Ongoing monitoring will confirm long‑term outcomes, but the early data suggest a new era of personalised, cost‑effective breast‑cancer care.