Safety and Tolerability of Anthracycline-Containing Adjuvant Chemotherapy in Elderly High-Risk Breast Cancer Patients.

Abstract:

BACKGROUND:Intensive chemotherapy confers benefit to patients with high-risk early breast cancer (BC). We characterized the feasibility and toxicity profile of anthracycline-containing adjuvant chemotherapy (ACAC) in older women with early BC. PATIENTS AND METHODS:Available data from women who received ACAC for BC in 3 randomized trials were retrieved. We identified women aged >65 years and we examined differences in tolerability and delivery of chemotherapy, toxicity, and treatment outcome. RESULTS:From a total of 2640 patients, we identified 453 patients (17%) as being >65 years old, 89% of whom had tumors that were node-positive, with 77% who were hormone receptor-positive. At least 90% of the planned doses were delivered in 37% of the elderly, compared with 49% in the younger patients (P < .0001). Grade 3 and 4 hematological toxicity was observed in 32% of elderly patients, compared with 21% of the younger (P < .0001). Febrile neutropenia occurred in 4.5% of the elderly patients, as opposed to 2.0% in the younger patients (P < .002). Elderly patients experienced more frequent Grade 3 and 4 fatigue, mucositis, and sensory neuropathy. Relative dose intensities were significantly lower in elderly patients. Treatment discontinuation was not different in the 2 groups. At a median follow-up of 120 months, competing risks analysis showed a significant benefit in disease-free survival for elderly patients. CONCLUSION:Elderly BC patients treated with ACAC derive clinical benefit comparable to that in younger patients, mainly at the cost of increased risk of hematological toxicity. This should be taken into account in decision-making and treatment individualization in high-risk BC patients.

journal_name

Clin Breast Cancer

journal_title

Clinical breast cancer

authors

Karavasilis V,Papadimitriou C,Gogas H,Kouvatseas G,Pentheroudakis G,Koutras A,Christodoulou C,Bafaloukos D,Samantas E,Pisanidis N,Papakostas P,Aravantinos G,Karanikiotis C,Kosmidis P,Pectasides D,Dimopoulos MA,Fountzilas

doi

10.1016/j.clbc.2015.12.001

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

291-298.e3

issue

4

eissn

1526-8209

issn

1938-0666

pii

S1526-8209(15)00296-7

journal_volume

16

pub_type

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