Clinical feasibility of (neo)adjuvant taxane-based chemotherapy in older patients: analysis of >4,500 patients from four German randomized breast cancer trials

INTRODUCTION: Despite the fact that people older than 65 years of age have the highest incidence of developing breast cancer, these patients are excluded from clinical trials in most cases. Furthermore, most physicians t
INTRODUCTION: Despite the fact that people older than 65 years of age have the highest incidence of developing breast cancer, these patients are excluded from clinical trials in most cases. Furthermore, most physicians tend towards therapy regimens without the use of dose-dense, highly active taxane-based treatments because of a lack of data regarding toxicities of these compounds in older patients.

METHODS: Pooled side-effect data were analyzed from four prospective, randomized clinical trials in which patients of different age groups (< 60 years, between 60 and 64 years, and > 64 years) with primary breast cancer received taxane-based chemotherapy.

RESULTS: Dose delays, dose reductions, hospitalization, and therapy discontinuation increased with age. Hematologic toxicities and some nonhematologic toxicities were generally more common in older patients. Leucopenia increased from 55.3% in patients aged < 60 years to 65.5% in patients aged > 64 years (P < 0.001), and neutropenia increased from 46.9% to 57.4% (P < 0.001). There was no difference, however, in clinically more relevant febrile neutropenia between the different age groups. Thrombopenia shows a similar age-dependent increase, whereas there is no difference between the age groups concerning anemia. Hot flushes and elevated liver enzymes decreased with increasing age.

CONCLUSIONS: The present pooled analysis of a substantial cohort of older primary breast cancer patients demonstrates that taxane-containing (neo)adjuvant chemotherapy is feasible in older patients and that toxicity can be reduced by sequential therapy regimens.
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Author:Sibylle Loibl, Gunter von Minckwitz, Nadia Harbeck, Wolfgang Janni, Dirk Elling, Manfred Kaufmann, Holm Eggemann, Valentina Nekljudova, Harald Sommer, Marion Kiechle, Sherko Kümmel
URN:urn:nbn:de:hebis:30:3-273787
DOI:http://dx.doi.org/10.1186/bcr2144
ISSN:1465-5411
ISSN:1465-542X
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=18796139
Parent Title (English):Breast cancer research
Publisher:London
Place of publication:BioMed Central
Document Type:Article
Language:English
Date of Publication (online):2008/09/16
Date of first Publication:2008/09/16
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2012/11/16
Volume:10
Issue:(5):R77
Pagenumber:13
First Page:1
Last Page:13
Note:
© 2008 Loibl et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0

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