A Real-World Data Retrospective Cohort Study of HER2-positive, Early-Stage Breast Cancer in Patients 70 Years of Age or Older: Natural History, Treatment Patterns, and Outcomes.

Autor: Bari S; Department of Hematology and Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Li J; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Kang D; Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Jameel Z; Department of Anatomic and Clinical Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Czerniecki BJ; Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL., Costa RLB; Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Electronic address: ricardo.costa@moffitt.org.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2023 Jun; Vol. 23 (4), pp. 378-387. Date of Electronic Publication: 2023 Feb 04.
DOI: 10.1016/j.clbc.2023.01.013
Abstrakt: Purpose: Early-stage human epidermal growth factor receptor 2-positive (HER2-positive) breast cancers (BCs) are routinely treated with intense perioperative chemotherapy combined with HER2-targeted agents. There is thus an unmet need for knowledge about treatment patterns and outcomes among patients 70 years of age or older, as this is an under-represented subset of patients in large clinical trials.
Methods: We used a deidentified cohort derived from a nationwide electronic health record database to conduct a retrospective cohort study of patients with HER2-positive BCs. Descriptive statistics were used to evaluate tumor characteristics, treatment patterns across age groups, and pathologic complete response rates. We used Kaplan-Meier survival curves to estimate recurrence-free and overall survivals; Cox proportional methods were used for adjustments with covariates of interest, including age as a categorical variable.
Results: We included 395 patients with HER2-positive stage I to III BCs who were 70 years of age or older. Most patients had tumors with high nuclear-grade T2 tumors, and received surgical treatment first. Most patients (61.7%) who received HER2 therapies underwent treatment in the adjuvant setting; paclitaxel and trastuzumab combination was the most commonly used adjuvant regimen. Older age was associated with increased hazard of recurrence or death. We did not detect significant evidence of decline in performance status, but there was modest weight drop after perioperative HER2 treatments.
Conclusion: Findings suggest that patients in this older-age cohort were treated with de-escalated perioperative strategies and had poorer outcomes; our findings should be validated in future studies.
(Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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