The recent medical opinion that anthracyclines (such as Adriamycin) are not effective in breast cancer patients that are HER2 negative is now joined by a potential test to further refine who will benefit from these chemotherapy drugs, which generally make patients very sick and are dangerous enough to cause permanent heart damage in some people.
Two genes were studied, and the mechanism of the action of one of the genes is fascinating: cancer cells with this gene sequester the toxin outside the nucleus, where it needs to be to kill the cell. The result is high resistance to Adriamycin (doxorubicin), which up to this point has been offered commonly and indiscriminately to many women with stage II cancer and above. So women with the gene who suffer through a common chemotherapy such as TAC (Taxol-Adriamycin-Cytoxan) are much more likely to have a recurrence than women without the gene.
About 20% of sampled patients in the study had the gene, and they had worse outcomes than the majority of women. The good news is that the authors find that cancer cells resistant to this class of chemo drugs are still susceptible to others. And, genetic tests these days are pretty simple and cheap to conduct (despite what companies like Myriad Genetics might tell you).
Big Pharma shouldn’t be too worried. Surely they will fight tooth and nail to patent as many genetic tests related to cancer as possible. But they’d better get cracking, because they missed this one. And it’s easy to imagine that perhaps an executive or two at a few companies would secretly rather this information weren’t available at all, because that will cut in on their profits. But perhaps this is overly cynical – surely it’s just those who don’t know someone with breast cancer who would have a tendency to feel that way. Of course, at the rate things are going, eventually most of them will.