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Innovative trial aims to save patients unnecessary chemotherapy

Dr Apurna Jegannathen, consultant oncologist and Ida Bentley, cancer patient

Breast cancer patients at University Hospitals of North Midlands NHS Trust (UHNM) are benefitting from an innovative new approach to cancer treatment. The OPTIMA (Optimal Personalised Treatment of early breast cancer using Multi-parameter Analysis) trial aims to establish how responsive a patient’s tumour will be to chemotherapy.

The ‘Prosigna’ test - used as part of the trial - examines how genes work in a sample of cancer tissue.

UHNM has become the top recruiter to the trial in the UK, leading out of 111 other trusts.

67-year-old Ida Bentley, of Stafford, was diagnosed with breast cancer in 2018. Ida took part in the OPTIMA trial and underwent chemotherapy after results from the Prosigna test established she would benefit from the treatment. She is now in remission. 

Ida said: “I found a lump in my armpit and went to the GP. At first I wasn’t too concerned, thinking that I’d likely be one of the ‘worried well’. But it turned out there was an issue and in fact I had an additional lump.

“Initially, my cancer diagnosis rendered me powerless. But I found that one way to regain power was to do as much research as I could. I had the option of joining another trial, but I decided OPTIMA was the best one for me.

“I feel it was worth taking part in the trial because as a result I knew then for sure that chemotherapy was the best NHS treatment option for me. It gave me peace of mind and a sense of reassurance.

“Although I would never wish to have cancer, surprisingly I feel the experience has resulted in some changes to my life that have been both constructive and positive. You don’t lose anything by being involved and you may potentially be helping in the development of treatment options for future patients.”

The trial began in July 2017 and will end in December 2021.

To date 2679 people are taking part in the trial across the UK, with 68 recruited at UHNM.

Dr Apurna Jegannathen, consultant oncologist, said: “Chemotherapy tends to be given as standard treatment to all patients after breast surgery and this can sometimes subject them to unnecessary side effects and poor emotional wellness.

“Not all patients with early breast cancer benefit from chemotherapy after surgery and it is possible that they will do as well with hormone therapy even when their tumour grade is high.

“Using Prosigna as part of the OPTIMA trial means that we can get an idea of how responsive a patient’s cancer is likely to be to chemotherapy and therefore if it is worth administering as a treatment.

“It’s phenomenal that UHNM is leading the way on this trial and we will work hard to keep up the momentum and continue to maintain and secure this position, which will ensure as many people as possible have the chance to benefit from this important research.

“There is no doubt that the trial and subsequent treatment has extended Ida’s life.”

Alison Myatt, senior research practitioner at UHNM, said: “This is a very important and exciting trial which could change our current standard of care practice, including a reduction in the need for certain patients requiring chemotherapy treatment. Patients may also be able to avoid unwanted and unnecessary treatment side effects, which will improve their quality of life significantly.

“The success of recruitment to the trial rests with many dedicated staff in the breast care team, clinical and medical oncologists, supporting doctors, registrars and senior research practitioners, who work collaboratively to assess patients’ suitability for entry to the trial.

“The OPTIMA trial serves to demonstrate how research can make a real change in practice. Without the support of the public we would not be able to make these advances in care, so we really appreciate people being involved.”