The gene is called  IL28B and it codes for the immune molecule interferon--3. Patients with specific genetic alterations around IL28B are twice as likely to benefit from drug treatment compared to other patients.  And it turns out the “good response gene” is much more common in patients of European ancestry compared to those of African-American ancestry.  That helps to explain why many fewer African-American’s respond to the treatment.

According to a Nature press release: “The findings represent the strongest study of predictors of treatment response to date, and may be of immediate clinical use in the development of a test for those considering treatment for hepatitis C.”

These types of genetic tests are relatively easy to make. There are many laboratories around the world that could conceivable create this test within a few hours.  The important thing, says John Compton of GeneDx is that a finding like this needs to be confirmed in another study before most doctors will consider prescribing it.

But treatment for hepatitis C is ardous:  It usually takes 48 weeks of therapy, and the medicines have potentially serious side effects.  If this test does indeed work, it will be extremely valuable to hepatitis C patients who are considering the standard therapy.

The study looked at three types of patients, the first group was those with no sign of spread to the nodes.  The next group showed very small traces of cancer in their nodes, including “micrometastases” or “isolated tumor cells.”  Half of these patients received more aggressive therapy, including additional drugs and chemotherapy.  The other half did not get aggressive treatment.

The study hoped to answer whether those tiny traces of tumors made a big difference or not.  It seems that they do.  Many more women that were in the second group (i.e. node positive) and got aggressive treatment lived beyond five years.

The authors point out that since the study was begun, doctors are treating this kind of breast cancer more aggressively anyway, so it is likely that most women with these traces of cancers in their nodes are already getting the more aggressive treatment.

If you’ve been diagnosed with breast cancer, ask your doctor about this study and what it means to you.

REFERENCE: de Boere, et al. “Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer,” NEJM, August 13, 2009: 653-663.

My three favorite questions are:

Why should I enroll in this particular trial?

What do we know about the drug that is being studied?

Would you recommend a relative participate in this trial?