[Lani]

I think the answer is always "we can't at this time recommend this be done in a
clinical setting" because they have not yet done prospective clinical trials in a large population to validate their findings"

Even once that is accomplished, and it takes years, they are hesitant to say that clinical procedure should be changed as malpractice suits are based on "standard of care"

"gold standards" change slowly.

The test is not widely available, has not be validated as accurate between labs and hasn't be validated in a large population as giving information sufficiently accurately to change treatment protocols.

EVEN if this turns out to be a wonderful biomarker for prevention of chemobrain, they have to look at what the alternatives are ie, whether it will alter treatment--and as their are no non-chemo containing regimens yet approved for her2+ bc it will probably take until there are (and then some) for these findings to change the way her2+ bc is treated

I hope some trials for non-chemo based regimens, which have to compare the new regimen vs. chemo+ one targeted treatment regimen will measure their patients COMT levels of those in both regimens to see if those who otherwise might have been predisposed to chemo brain got to avoid it by having the purely targeted regimen

Such trials will be costly (two targeted agents) and take time..perhaps in the meantime they will get to understand more about whether all chemos' chemobrain are related this gene or only some. If the chemo culprit is also being used vs other cancers, maybe the answer will come from research into people being treated for those.