Bridging The Age Gap: observational cohort study of effects of chemotherapy and trastuzumab on recurrence, survival and quality of life in older women with early breast cancer

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RING, A., BATTISTI, N.M.L., REED, M.W.R., HERBERT, E., MORGAN, J.L., BRADBURN, M., WALTERS, S.J., COLLINS, K.A., WARD, S.E., HOLMES, G.R., BURTON, Maria, LIFFORD, K., EDWARDS, A., ROBINSON, T.G., MARTIN, C., CHATER, T., PEMBERTON, K.J., BRENNAN, A., CHEUNG, K.L., TODD, A., AUDISIO, R.A., WRIGHT, J., SIMCOCK, R., GREEN, T., REVELL, D., GATH, J., HORGAN, K., HOLCOMBE, C., WINTER, M.C., NAIK, J., PARMESHWAR, R., GOSNEY, M.A., HATTON, M.Q., THOMPSON, A.M., WYLD, L., COLLINS, K., WARD, S., HOLMES, G., MORGAN, J., BRADBURN, M., WALTERS, S., BURTON, M., EDWARDS, A., BRAIN, K., RING, A., ROBINSON, T., PEMBERTON, K., SHRESTHA, A., NETTLESHIP, A., RICHARDS, P., CHEUNG, K.L., HARDER, H., AUDISIO, R., WRIGHT, J., SIMCOCK, R., MURRAY, C., THOMSON, A.M., GOSNEY, M., HATTON, M., ARMITAGE, F., PATNICK, J., GREEN, T., REVILL, D., HORGAN, K., HOLCOMBE, C. and WINTER, M. (2021). Bridging The Age Gap: observational cohort study of effects of chemotherapy and trastuzumab on recurrence, survival and quality of life in older women with early breast cancer. British Journal of Cancer, 125 (2), 209-219. [Article]

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Abstract

Background: Chemotherapy improves outcomes for high risk early breast cancer (EBC) patients but is infrequently offered to older individuals. This study determined if there are fit older patients with high-risk disease who may benefit from chemotherapy. Methods: A multicentre, prospective, observational study was performed to determine chemotherapy (±trastuzumab) usage and survival and quality-of-life outcomes in EBC patients aged ≥70 years. Propensity score-matching adjusted for variation in baseline age, fitness and tumour stage. Results: Three thousands four hundred sixteen women were recruited from 56 UK centres between 2013 and 2018. Two thousands eight hundred eleven (82%) had surgery. 1520/2811 (54%) had high-risk EBC and 2059/2811 (73%) were fit. Chemotherapy was given to 306/1100 (27.8%) fit patients with high-risk EBC. Unmatched comparison of chemotherapy versus no chemotherapy demonstrated reduced metastatic recurrence risk in high-risk patients(hazard ratio [HR] 0.36 [95% CI 0.19–0.68]) and in 541 age, stage and fitness-matched patients(adjusted HR 0.43 [95% CI 0.20–0.92]) but no benefit to overall survival (OS) or breast cancer-specific survival (BCSS) in either group. Chemotherapy improved survival in women with oestrogen receptor (ER)-negative cancer (OS: HR 0.20 [95% CI 0.08–0.49];BCSS: HR 0.12 [95% CI 0.03–0.44]).Transient negative quality-of-life impacts were observed. Conclusions: Chemotherapy was associated with reduced risk of metastatic recurrence, but survival benefits were only seen in patients with ER-negative cancer. Quality-of-life impacts were significant but transient. Trial Registration: ISRCTN 46099296.

More Information

Official URL:

https://www.nature.com/articles/s41416-021-01388-9

Open Access URL:

https://www.nature.com/articles/s41416-021-01388-9...

Open Access Version:

Published version

Uncontrolled Keywords:

Age Gap TMG; Oncology & Carcinogenesis; 1112 Oncology and Carcinogenesis; 1117 Public Health and Health Services

Page Range:

209-219

Event Location: