Dr Martine Piccart and her colleagues have today published in the New England Journal of Medicine their results of the landmark international prospective randomized Microarray In Node negative Disease May Avoid Chemotherapy (MINDACT) study. MINDACT assessed MammaPrint genomic testing of nearly 7,000 women with early breast cancer. In Australia, Associate Professor Guy Hingston says that this is the biggest news in breast cancer management in 2016!
Going against the prevailing Australian view at the time, Associate Professor Guy Hingston commenced using this modern international genomic test in northern NSW in 2014, and published his initial MammaPrint results back then in the Asia Pacific Journal of Oncology. However, with the publication of MINDACT today, Associate Professor Guy Hingston considers that MammaPrint is now set to become the international standard of care in genomic testing in breast cancer. “MammaPrint testing has now been shown to be the most reliable international testing platform for the genomic assessment (of approximately one third) of women who present with a new diagnosis of early breast cancer. This means that each year in Australia, around 5,000 Australian women could benefit from this new technology.”
“MammaPrint is the first genomic test in early breast cancer that has been shown through a prospective randomised international five year follow up cohort of nearly 7,000 women to be both prognostic and predictive.” As of today, Associate Professor Guy Hingston recommends that all Australian women who are about to undergo chemotherapy for early breast cancer should now check with their medical oncologist to see if they could benefit from MammaPrint testing. He has made this bold statement because MINDACT has shown that there is a 46% reduction in the need for adjuvant chemotherapy in the subgroup of women who have hormone positive breast cancers between 20mm and 50mm in diameter, including those with node negative or node positive disease (with up to three nodes involved).
According to Associate Professor Guy Hingston, MINDACT has shown that there is no advantage for undergoing chemotherapy if the MammaPrint genomic test returns a low risk result, as the large group of women in MINDACT randomized to receive or not receive chemotherapy obtained no statistically significant benefit in terms of 5 year distant metastasis free survival or overall survival. Therefore, Associate Professor Guy Hingston asks why women should needlessly undergo all of the side effects, and run the risk of major complications of having chemotherapy, if no benefit is to be obtained? More information about MINDACT and MammaPrint testing can be obtained online at www.mammaprint.com.au.
Back in late 2013, and to help Australian women access this new technology, Associate Professor Guy Hingston set up a company called Genome Investigation Pty Ltd which now assists Australian women to obtain this form of breast cancer testing. Genome Investigation also commenced an application for public funding of MammaPrint through the Australian Government Department of Health Medical Services Advisory Committee. While this application remains afloat, it is Associate Professor Guy Hingston’s view that today’s publication of MINDACT means that the Department of Health should now immediately commence funding of MammaPrint testing for those women who are eligible, after appropriate referral from a specialist oncologist.
“As of today, and because of MammaPrint testing proven through MINDACT, we now live and work in a different world of breast cancer management. Women already shattered with a new diagnosis of breast cancer, should not needlessly be put through chemotherapy, if genomically their cancer can be shown to have a low risk of recurrence. As a medical profession, we are here to help women, not hurt them, and this form of genomic testing is a great step forward in our ability to more accurately target treatment and provide personalized cancer therapy.”
Further, Associate Professor Guy Hingston states that we are now heading into an exciting era of breast cancer management, where over-treatment is being replaced with targeted treatment. Surgical oncologists initially lead the way with partial mastectomy (avoiding mastectomy), and then sentinel node biopsy (avoiding unnecessary axillary clearance). However, proven MammaPrint genomic testing is now leading the way with more personalized targeted medical treatment options, and this is great news for all those involved in breast cancer management, both patients and clinicians alike.”
Associate Professor Guy Hingston is an expert in the clinical management of breast cancer, with nearly 20 years of clinical experience as a specialist surgical oncologist. He currently resides in Port Macquarie, where he maintains a private practice in oncoplastic breast care. However, he is currently trying to establish a significant breast cancer research project through the Hunter Medical Research Institute, and is focused on establishing the genomic basis of breast cancer using next generation sequencing technology looking for the underlying somatic breast cancer mutations. He sees this as the next important practical step which is needed to help women with a new diagnosis of breast cancer. For further information on Associate Professor Guy Hingston, please visit www.drguy.com.au.