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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Embargo End Date
ICR Authors
Authors
Ring, A
Battisti, NML
Reed, MWR
Herbert, E
Morgan, JL
Bradburn, M
Walters, SJ
Collins, KA
Ward, SE
Holmes, GR
Burton, M
Lifford, K
Edwards, A
Robinson, TG
Martin, C
Chater, T
Pemberton, KJ
Brennan, A
Cheung, KL
Todd, A
Audisio, RA
Wright, J
Simcock, R
Green, T
Revell, D
Gath, J
Horgan, K
Holcombe, C
Winter, MC
Naik, J
Parmeshwar, R
Gosney, MA
Hatton, MQ
Thompson, AM
Wyld, L
Age Gap TMG
Battisti, NML
Reed, MWR
Herbert, E
Morgan, JL
Bradburn, M
Walters, SJ
Collins, KA
Ward, SE
Holmes, GR
Burton, M
Lifford, K
Edwards, A
Robinson, TG
Martin, C
Chater, T
Pemberton, KJ
Brennan, A
Cheung, KL
Todd, A
Audisio, RA
Wright, J
Simcock, R
Green, T
Revell, D
Gath, J
Horgan, K
Holcombe, C
Winter, MC
Naik, J
Parmeshwar, R
Gosney, MA
Hatton, MQ
Thompson, AM
Wyld, L
Age Gap TMG
Document Type
Journal Article
Date
2021-07-20
Date Accepted
2021-03-31
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.
Citation
British Journal of Cancer, 2021, 125 (2), pp. 209 - 219
Source Title
British Journal of Cancer
Publisher
SPRINGERNATURE
ISSN
0007-0920
eISSN
1532-1827
1532-1827
1532-1827
Collections
Research Team
Breast Cancer Clin Res