Optima Trial

Hi I’m 2 weeks post surgery left sided mastectomy tumour was 4.5cm and axillary node clearance where 4 out of 16 nodes were affected. I have been contacted today to see if I would take part in the trial. I’m so confused as what to do, I have oncology appointment next week. With the tumour size and nodes affected would Chemo be a treatment option anyway?

  • Hi Debs_l,

    Thanks for getting in touch and welcome to the online community. Making decisions about treatments during a cancer journey, can seem like a mind field to understand.

    Deciding whether to take part in a clinical trial can be a difficult decision for someone to make. Most clinical trials are aimed at looking at what patients may benefit most from treatment or gaining evidence about how safe or effective a treatment can be. This is needed before tests or treatments are deemed to be effective and released for mainstream use. Doctors need clinical trials to know which new or combined treatments or tests are safe and work better than treatments we already have.

    It can mean at times there is therefore not enough evidence, information or guarantees as to how effective entering into a trial will be for the individual.

    It may be worthwhile having your clinical nurse specialist or consultant to understand more about the optima trial and why you may benefit from this. Your team are the best placed to advise of the individual implications of entering this trial as they know your medical history and cancer best.

    Your team can also discuss what may be involved in a clinical trial and help with any concerns and questions you are having. As with any treatments, clinical trials have pro’s and cons to taking part that you may want to consider.

    The Optima trial is trying to understand and help predict which people with breast cancer who will benefit most from having chemotherapy. Currently the decision is based on simple factors: the size of the cancer, if it has spread to nearby lymph nodes and what it looks under a microscope. New research has shownthat  this way to decide on treatment can have limitations and that not everyone will necessarily need chemotherapy.

    The trial is looking at using a test called the prosigna test. Which looks closely at an area of breast tissue to look at the genes in the cancer cells and how they work. It predicts how likely breast cancer is to spread to somewhere in the body within 10 years, in people who will be taking hormone therapy for at least five years. In patients with the highest risk, chemotherapy can help reduce the chance of cancer coming back.

    Cancer research UK further information on the Optima trial that may be useful to read over.

    As discussed, current treatment decisions to use chemotherapy are based on your tumour size, are lymph nodes affected, hormone sensitivity. This new test is hoped to identify those who while benefit most from chemotherapy and to identify those who do not need unnecessary treatment.

    Health talk has some further information about clinical trials including people’s personal experiences that you may find helpful.

    I noticed that on breast cancer now and our online breast cancer group there has been some chat with people faced with the same decision about the optima trial. This may be interesting to look over.

    It may also be helpful to give one of our nurses a call directly to talk things over in more depth. We are always happy to help and advise.

    Best wishes


    Macmillan Cancer In formation Nurse Specialist