Simple, low-cost intervention increase cure rates, survival of breast cancer patients: Tata Memorial Centre study
Dr Rajendra Badwe, Director, Tata Memorial Centre, Mumbai presented the findings at the ongoing European Society of Medical Oncology (ESMO) Congress in Paris
Dr Rajendra Badwe, Director, Tata Memorial Centre, Mumbai presented the results of a landmark multi-centre Indian study on breast cancer. The results of the study show that this simple, low-cost intervention significantly and substantially increases the cure rates and survival of breast cancer patients, with a benefit that is ongoing for several years after surgery. The injection requires no additional expertise, is inexpensive, and can result in saving up to 100,000 lives annually globally. These benefits are substantial and were achieved with an intervention the cost of which was less than Rs 100 per patient.
For comparison, benefits of far lesser magnitude have been achieved in early breast cancer patients by much more expensive, targeted drugs which cost more than ten lakhs per patient. The clinical trial is hence an important milestone in the treatment of breast cancer. The trial in women undergoing breast cancer surgery involved the injection of a commonly used drug around the tumour, on the operating table, just before surgery.
Dr Badwe presented these findings at the ongoing European Society of Medical Oncology (ESMO) Congress in Paris, one of the most prestigious cancer conferences in the world held annually in Europe. A press conference to announce the results of the trial was arranged, simultaneously with the live streaming of the presentation, followed by the address by Dr Sudeep Gupta, Professor of Medical Oncology, Tata Memorial Centre/Hospital & Homi Bhabha National Institute and Director, ACTREC.
Dr Badwe commented, “This is the first study of its kind globally, that has shown a sizable benefit by single intervention before surgery. If implemented across the world, it can save over 100,000 lives annually. For scientists, it opens the window of peri-operative intervention to modulate the environment of cancer in such a way as to prevent its deleterious reaction to the act of surgery [observation]. Evolving low-cost interventions for cancer has been a mission of Tata Memorial Centre and Department of Atomic Energy for the benefit of Indian and global population and this study, supported by the Department of Atomic Energy, is a major step towards Atma Nirbhar Bharat.”
Dr Sudeep Gupta, Professor of Medical Oncology at TMC and Director ACTREC, one of the co-investigators of the study said, “This study provides an inexpensive and immediately implementable treatment in breast cancer which can be practised by every surgeon who treats this disease. The results from a large randomized trial, which is the gold-standard way of evaluating the worth of new treatments, provide the highest level of evidence to support the use of this technique. This study is proof that Indian centres can design and conduct studies which have a global impact.”
The study, ‘Effect of Peri-tumoral Infiltration of Local Anaesthetic Prior to Surgery on Survival in Early Breast Cancer’ is a randomised controlled trial, conceived and designed by Dr Badwe, who is the principal investigator. The study was conducted by investigators at 11 cancer centres in India including Tata Memorial Centre in Mumbai over 11 years between 2011 and 2022.
The study included 1,600 women with early breast cancer who were planned to be treated with surgery. Half of these patients, constituting the control group, received standard surgery followed by standard post-operative treatment including chemotherapy, hormone therapy and radiotherapy as per guidelines. The other half, constituting the intervention group, received an injection of a commonly used local anaesthesia agent, 0.5 per cent lidocaine, all around the tumour, just before surgery. They then underwent standard surgery followed by the same postoperative treatment as was given in the control group.
Dr Badwe’s previous research has suggested that there is a window of opportunity just before, during, and immediately after surgical removal of primary cancer when anti-cancer interventions could reduce the risk of development of disseminated stage 4 metastatic cancer later in the lifespan of the patient. Lignocaine, which is a commonly used, inexpensive, local anaesthesia drug, was thought to be one such suitable intervention because of its inhibitory effects on cancer cell division, movement and other anti-cancer properties. Depicted here is the diagrammatic representation of the technique of peri-tumoral injection which is simple and requires no additional expertise.
PIB
