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Outcomes of older adults with early-stage triple-negative breast cancer (TNBC) receiving chemotherapy: a single-institution experience.
Singareeka Raghavendra, Akshara; Liu, Diane; Shen, Yu; Barcenas, Carlos H; Ueno, Naoto T; Giordano, Sharon; Tripathy, Debu; Sri Karuturi, Meghan.
Afiliação
  • Singareeka Raghavendra A; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.
  • Liu D; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Shen Y; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Barcenas CH; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.
  • Ueno NT; University of Hawai'i Cancer Center, Honolulu, HI, USA.
  • Giordano S; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.
  • Tripathy D; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Sri Karuturi M; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.
Breast Cancer Res Treat ; 207(1): 81-90, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38916821
ABSTRACT

BACKGROUND:

Despite lower chemotherapy use in older triple-negative breast cancer (TNBC) patients, their outcomes match younger counterparts. We compared outcomes in early-stage TNBC patients by age receiving chemotherapy at a major cancer center with a national TNBC database.

METHODS:

Retrospective study using institutional data on stage I-III TNBC (ER/PR < 10%) women with neoadjuvant/adjuvant chemotherapy. Based on their ages at diagnosis, patients were stratified into four categories ≤40, 41-59, 60-69, and ≥ 70 years. Demographic and clinical characteristics recorded included race, disease stage, ER/PR positivity, treatment regimen, lymphatic or vascular invasion (LVI), histologic grade, Ki-67 level, body mass index (BMI), and pathologic complete response (pCR) following neoadjuvant treatment and are summarized using descriptive statistics. The primary endpoints were overall survival (OS), disease-free survival (DFS), and distant disease-free survival (DDFS); all were estimated using the Kaplan-Meier method. Both univariate and multivariate (MV) Cox regressions were applied to evaluate the impact of important covariates on these time-to-event endpoints.

RESULTS:

Of the 2336 patients studied, 492 (21.1%) were ≤ 40 years old, 1239 (53.1%) were 41-59, 461 (19.7%) were 60-69, and 144 (6.2%) were ≥ 70. In the univariate regression model of OS/DFS/DDFS, age ≥ 70 was significantly associated with worse OS (p = 0.0217); other factors associated with worse OS were non-anthracycline-based chemotherapy, higher tumor stage, and neoadjuvant chemotherapy. The multivariate Cox regression model, adjusted for race and stage, showed no significant effects of age on OS; however, patients ≥ 70 years old who received non-anthracycline treatment combinations had worse DFS (hazard ratio = 0.349 vs. 1.049, p = 0.0293) and DDFS (hazard ratio = 0.317 vs. 1.016, p = 0.0251) than patients ≤ 40 years old. DFS from MV model after adjusting for age, race, and disease stage, the hazard ratio between anthracycline + taxane treatments and anthracycline + other treatments in patients ≥ 70 years old was statistically significantly lower than in patients ≤ 40 years old (hazard ratios [HRs] = 0.349 vs. 1.049, p = 0.0293).

CONCLUSIONS:

Our findings indicate that outcomes such as DFS are less favorable in older compared to younger patients with early-stage TNBC, primarily in those who did not receive an anthracycline based chemotherapy regimen.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Terapia Neoadjuvante / Neoplasias de Mama Triplo Negativas / Estadiamento de Neoplasias Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Breast Cancer Res Treat Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Terapia Neoadjuvante / Neoplasias de Mama Triplo Negativas / Estadiamento de Neoplasias Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Breast Cancer Res Treat Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos