Outcome after neoadjuvant chemotherapy in elderly breast cancer patients - a pooled analysis of individual patient data from eight prospectively randomized controlled trials
von Waldenfels G, Loibl S, Furlanetto J, Machleidt A, Lederer B, Denkert C, Hanusch C, Kümmel S, von Minckwitz G, Schneeweiss A, Untch M, Rhiem K, Fasching P, Blohmer JU (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 9
Pages Range: 15168-15179
Journal Issue: 20
DOI: 10.18632/oncotarget.24586
Abstract
Introduction: Recent studies showed the high and independent impact of age (<40 years) on pathologic complete response (pCR) and prognosis for patients undergoing neoadjuvant chemotherapy (NACT). Some physicians might not consider elderly patients (>65 years) for NACT due to poor prognosis or higher toxicity. The aim of this analysis is to help selecting appropriately elderly women who would benefit from NACT. Secondly, survival parameters are investigated in several histological subgroups. Methods: From 1998 to 2010, eight prospectively randomized German Breast Group (GBG) trials of anthracycline- and taxane-based NACT were performed and analyzed in this study. Results: Compared to the overall average, elderly women had significant larger tumors and more overall lymph node involvement. Histologically, they had more G2 tumors, more estrogen-receptor positive tumors. pCR (ypT0 ypN0) was strongly associated with age. The multivariable logistic regression analysis of clinical parameters showed that young age, clinical stage T4, invasive ductal cancer and poor differentiated breast cancer are predictive for high pCR. The multivariate analyses of molecular subgroups showed that age >65years is a predictor of significant lower pCR in HER2- breast cancers. Nonetheless, HER2+ patients showed pCR rates as high- and HR+/HER2+ even higher - pCR rates compared to younger patients. Discussion: This study underlines the unfavorable impact of higher age on pCR, but it shows a realistic chance for pCR if NACT is applied - especially for HER2+ patients. Furthermore, elderly patients with non-TNBC showed a good prognosis (comparable to younger patients) regarding overall survival, even if they do not have pCR.
Authors with CRIS profile
Involved external institutions
Charité - Universitätsmedizin Berlin
Germany (DE)
GBG Forschungs GmbH (German Breast Group)
Germany (DE)
Rotkreuzklinikum München
Germany (DE)
Kliniken Essen-Mitte
Germany (DE)
Deutsches Krebsforschungszentrum (DKFZ)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Universitätsklinikum Köln
Germany (DE)
Germany (DE)
GBG Forschungs GmbH (German Breast Group)
Germany (DE)
Rotkreuzklinikum München
Germany (DE)
Kliniken Essen-Mitte
Germany (DE)
Deutsches Krebsforschungszentrum (DKFZ)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Universitätsklinikum Köln
Germany (DE)
How to cite
APA:
von Waldenfels, G., Loibl, S., Furlanetto, J., Machleidt, A., Lederer, B., Denkert, C.,... Blohmer, J.U. (2018). Outcome after neoadjuvant chemotherapy in elderly breast cancer patients - a pooled analysis of individual patient data from eight prospectively randomized controlled trials. Oncotarget, 9(20), 15168-15179. https://doi.org/10.18632/oncotarget.24586
MLA:
von Waldenfels, Gabriel, et al. "Outcome after neoadjuvant chemotherapy in elderly breast cancer patients - a pooled analysis of individual patient data from eight prospectively randomized controlled trials." Oncotarget 9.20 (2018): 15168-15179.
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