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- Ring, A. (author)
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
- Article/chapterEnglish2021
Publisher, publication year, extent ...
- 2021-05-10
- Springer Science and Business Media LLC,2021
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- LIBRIS-ID:oai:gup.ub.gu.se/308947
- https://gup.ub.gu.se/publication/308947URI
- https://doi.org/10.1038/s41416-021-01388-9DOI
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- Language:English
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- 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. © 2021, The Author(s).
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- Battisti, N. M. L. (author)
- Reed, M. W. R. (author)
- Herbert, E. (author)
- Morgan, J. L. (author)
- Bradburn, M. (author)
- Walters, S. J. (author)
- Collins, K. A. (author)
- Ward, S. E. (author)
- Holmes, G. R. (author)
- Burton, M. (author)
- Lifford, K. (author)
- Edwards, A. (author)
- Robinson, T. G. (author)
- Martin, C. (author)
- Chater, T. (author)
- Pemberton, K. J. (author)
- Brennan, A. (author)
- Cheung, K. L. (author)
- Todd, A. (author)
- Audisio, Riccardo AGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery(Swepub:gu)xaudri (author)
- Wright, J. (author)
- Simcock, R. (author)
- Green, T. (author)
- Revell, D. (author)
- Gath, J. (author)
- Horgan, K. (author)
- Holcombe, C. (author)
- Winter, M. C. (author)
- Naik, J. (author)
- Parmeshwar, R. (author)
- Gosney, M. A. (author)
- Hatton, M. Q. (author)
- Thompson, A. M. (author)
- Wyld, L. (author)
- Collins, K. (author)
- Ward, S. (author)
- Holmes, G. (author)
- Morgan, J. (author)
- Bradburn, M. (author)
- Walters, S. (author)
- Burton, M. (author)
- Lifford, K. (author)
- Edwards, A. (author)
- Brain, K. (author)
- Ring, A. (author)
- Robinson, T. (author)
- Pemberton, K. (author)
- Shrestha, A. (author)
- Nettleship, A. (author)
- Richards, P. (author)
- Cheung, K. L. (author)
- Harder, H. (author)
- Audisio, R. (author)
- Battisti, N. M. L. (author)
- Wright, J. (author)
- Simcock, R. (author)
- Murray, C. (author)
- Thomson, A. M. (author)
- Gosney, M. (author)
- Hatton, M. (author)
- Armitage, F. (author)
- Patnick, J. (author)
- Green, T. (author)
- Revill, D. (author)
- Gath, J. (author)
- Horgan, K. (author)
- Holcombe, C. (author)
- Winter, M. (author)
- Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi (creator_code:org_t)
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- In:British Journal of Cancer: Springer Science and Business Media LLC125, s. 209-2190007-09201532-1827
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- Walters, S. J.
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- Holmes, G.
- Morgan, J.
- Walters, S.
- Brain, K.
- Robinson, T.
- Pemberton, K.
- Shrestha, A.
- Nettleship, A.
- Richards, P.
- Harder, H.
- Audisio, R.
- Murray, C.
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- Armitage, F.
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- Revill, D.
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