06/17/2026
Could more women with breast cancer safely avoid chemotherapy? New findings from the OPTIMA trial suggest the answer may be yes. It’s exciting news!
The OPTIMA trial, presented at ASCO, found that some women with hormone receptor-positive breast cancer may achieve the same outcomes with hormone-blocking therapy alone, avoiding the side effects and long-term impacts of chemotherapy.
The international study followed more than 4,000 women and used a genomic test called Prosigna to examine the biology of each tumour and estimate the risk of recurrence.
For women identified as having a low genomic risk score, outcomes were nearly identical whether they received chemotherapy or not. Five years later, 94% remained alive and cancer-free without chemotherapy.
Many Canadians are familiar with Oncotype DX, but the OPTIMA trial highlights the potential of another genomic test, Prosigna, to help guide treatment decisions and identify additional women who may safely avoid chemotherapy.
What are genomic tests?
Genomic tests examine the activity of genes within a tumour to help predict the risk of recurrence and whether treatments such as chemotherapy are likely to provide benefit. They are helping make breast cancer treatment more personalized and reducing unnecessary treatment when it is safe to do so.
🔹 Oncotype DX examines 21 genes and estimates whether chemotherapy is likely to provide benefit.
🔹 Prosigna analyzes 50 genes, identifies the cancer's molecular subtype, and estimates recurrence risk. The OPTIMA trial suggests it may help identify additional women who can safely avoid chemotherapy.
🔹 MammaPrint evaluates 70 genes and classifies cancers as either low risk or high risk for recurrence.
These tests use different approaches, but they share the same goal: ensuring women receive the treatment they need while helping some safely avoid treatment they may not need.
The findings reflect an important shift toward more personalized breast cancer care, where treatment decisions are guided by the biology of an individual's cancer rather than a one-size-fits-all approach.
Have you had genomic testing as part of your breast cancer treatment? When I was diagnosed I had to request Oncotype testing- it wasn't automatically offered to me. We'd love to hear about your experience. Did you have had to advocate for yourself? Were you able to avoid chemo? Please help us to inform others. Thank you.