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
Autor: | 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., Walters, S., Burton, M., Brain, K., Robinson, T., Pemberton, K., Shrestha, A., Nettleship, A., Richards, P., Harder, H., Audisio, R., Murray, C., Thomson, A.M., Gosney, M., Hatton, M., Armitage, F., Patnick, J., Revill, D., Winter, M. |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Oncology
Bridged-Ring Compounds medicine.medical_specialty Cancer Research medicine.medical_treatment Breast Neoplasms Article 03 medical and health sciences 0302 clinical medicine Breast cancer Quality of life Drug Therapy Trastuzumab Internal medicine medicine Chemotherapy Humans Anthracyclines 030212 general & internal medicine Prospective Studies Stage (cooking) Propensity Score Aged Aged 80 and over business.industry Hazard ratio Cancer medicine.disease Survival Analysis Treatment Outcome Patient Satisfaction 030220 oncology & carcinogenesis Quality of Life Observational study Female Taxoids business medicine.drug Cohort study |
Zdroj: | British Journal of Cancer |
ISSN: | 0007-0920 1532-1827 |
Popis: | 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 |
Databáze: | OpenAIRE |
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