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Genomic testing supports more precise treatment decisions for patients with early-stage breast cancer

Following a breast cancer diagnosis, the physician and patient must make one of the most important treatment decisions – whether chemotherapy will provide a meaningful benefit in the individual patient’s case.

The results of the Latvian pilot project “Implementation of New Molecular Genetic Diagnostic Methods for the Personalised Treatment of Breast Cancer Patients in Latvia” (hereinafter—the Pilot Project) demonstrate that genomic testing can support a much more precise selection of the most appropriate treatment for patients with early-stage breast cancer.

During the Pilot Project, 208 patients underwent genomic testing using the Oncotype DX® test. The results show that chemotherapy was not included in the treatment plans of 76% of patients following testing. For the remaining patients, chemotherapy was recommended based on the test results and other clinical parameters.

Approximately 1,200 women are diagnosed with breast cancer in Latvia every year. For certain groups of patients with early-stage breast cancer, international clinical guidelines recommend additional genomic analysis to assess the potential benefit of chemotherapy.

Published international evidence, together with the results of the Pilot Project conducted in Latvia, indicates that chemotherapy does not provide a meaningful additional benefit for a substantial proportion of these patients.

Until recently, treatment decisions were primarily based on tumour size, the extent of the disease and other clinical parameters. Genomic testing complements this information by analysing the tumour’s biology and helping the physician make a more individually informed treatment decision.

Dr Aija Geriņa, Chair of the Board of the Latvian Association of Medical Oncologist-Chemotherapists and Head of the Oncology Clinic at Pauls Stradiņš Clinical University Hospital, explains:

“Precision medicine is now an integral part of modern oncology. A personalised approach enables patients to receive the treatment that is most likely to provide the greatest therapeutic benefit. Effective cancer treatment today is difficult to imagine without genomic testing, which provides essential information about tumour biology. It helps us predict the course of the disease much more accurately, assess the potential benefit of chemotherapy and determine eligibility for targeted therapies. This allows treatment to be selected according to the genetic mutations and receptors present in the tumour cells, while avoiding therapies that are toxic and predicted to be ineffective.”

Anitra Greivule, a representative of GeneKor SIA, emphasises that genomic testing has become an important tool in the personalised treatment of breast cancer because it helps physicians assess the potential benefit of chemotherapy by analysing the tumour’s biology.

For appropriate patient groups, this approach is included in international clinical guidelines. “Personalised medicine is no longer a concept of the future—it is already an integral part of modern oncology. The more precise the information about the tumour, the better informed the treatment decision that the physician and patient can make together. This approach helps select the treatment that will provide the greatest benefit for the individual patient,” emphasises Anitra Greivule.

An independent economic analysis conducted by KPMG indicates that a personalised approach to treatment can benefit both patients and the healthcare system. Reducing the number of potentially unnecessary chemotherapy treatments can lower treatment costs and lessen the burden associated with adverse effects. The analysis concluded that, in the long term, every one euro invested in genomic testing generates approximately EUR 2.35 in economic benefit.

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