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Neoadjuvant systemic therapy in geriatric breast cancer patients: a National Cancer Database (NCDB) analysis.
Brown, Lauren; Naffouje, Samer A; Sam, Christine; Laronga, Christine; Catherine Lee, M.
Affiliation
  • Brown L; USF Health Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
  • Naffouje SA; Department of Surgical Oncology, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA.
  • Sam C; Senior Adult Oncology Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA.
  • Laronga C; Comprehensive Breast Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA.
  • Catherine Lee M; Comprehensive Breast Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA. marie.lee@moffitt.org.
Breast Cancer Res Treat ; 196(3): 441-451, 2022 Dec.
Article in En | MEDLINE | ID: mdl-36207620
PURPOSE: Neoadjuvant systemic therapy (NAST) can be an effective treatment option for patients with HER2 + or triple negative breast cancer (TNBC). However, its use in geriatric patients is largely understudied. Our aim is to investigate the effect of NAST in both septuagenarians and octogenarians with HER2 + or TNBC to better understand its role in the geriatric patient population. METHODS: We utilized the National Cancer Database (NCDB) to analyze female patients with HER2 + or TNBC between 70 and 89 years. We compared the baseline demographic and clinical characteristics of septuagenarians and octogenarians using mixed-effect modeling for continuous variables and conditional logistic regressions for categorical variables. Overall survival (OS) between several subgroups was compared based on a propensity score model. Kaplan-Meier method was used to calculate OS between the subgroups, and log-rank test was used to compare OS results. RESULTS: A total of 16,443 patients met inclusion/exclusion criteria, of which 92.9% had infiltrative ductal carcinoma and 73.5% were TNBC. Most patients received NAST as a first course of therapy (58.8%). Septuagenarians were more likely to receive NAST (65.9%), whereas octogenarians were more likely to receive upfront surgical resection (67.7%). Our analysis demonstrated OS benefit with NAST among patients who received surgical resection. However, in patients who received NAST, decline during therapy was associated with a significantly poorer OS outcomes in general. CONCLUSION: When combined with surgical resection, NAST is an effective treatment option in both septuagenarians and octogenarians. Nonetheless, careful selection of NAST recipients in this population remains critical to optimize patient outcome.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Triple Negative Breast Neoplasms Type of study: Prognostic_studies Limits: Aged / Aged80 / Female / Humans Language: En Journal: Breast Cancer Res Treat Year: 2022 Type: Article Affiliation country: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Carcinoma, Ductal, Breast / Triple Negative Breast Neoplasms Type of study: Prognostic_studies Limits: Aged / Aged80 / Female / Humans Language: En Journal: Breast Cancer Res Treat Year: 2022 Type: Article Affiliation country: United States