Abstract 3595
Background
Elderly breast cancer (BC) patients have been underrepresented in clinical trials whereas ∼60% of deaths from BC occur in women aged 65 years and older. The management of elderly women with early BC requires careful evaluation of risks and benefits of available treatment options. Clinical trials for elderly patients in the adjuvant setting are lacking, and efficacy results obtained in general population cannot be directly extrapolated to elderly patients without specific evidences. Therefore, we examined factors associated with the prescription of adjuvant chemotherapy (aCT) and the impact of this treatment on overall survival (OS) in a large cohort of patients aged 65 years and older.
Methods
Patients were retrospectively identified from a large cohort of 23,134 early BC patients who underwent primary surgery in 18 academic centres between 1990 and 2014. A binary logistic regression was built to identify the factors associated with aCT administration. The impact of aCT on OS was analysed using a multivariate Cox regression model including age, histology, grade, tumour size, lymphovascular invasion (LVI), nodal status and endocrine therapy (ET) and endocrine receptors (ER). A propensity score-based matching analysis was performed.
Results
Of 6605 patients aged 65 years and older, 1493 received aCT (22.6%). Administration of aCT was predominantly associated with macroscopic lymph node involvement (LNi) and ER-negative status but common predictors, such as age < 80 years, ductal histology, tumour size ≥ 20mm, ET and tumour grade were also found as statistically significant. In a Cox model including age, histology, LVI, tumour size, LNi, ET, ER and grade, aCT was significantly associated with better OS (HR 0.71, 95% CI 0.58 to 0.86; p < 0.001). Ten-year OS estimates in case-matched patients for propensity score analysis were 76.8% (95% CI 76.6 to 77.1) in the aCT group vs. 61.5% (95% CI 61.3 to 61.7) without aCT (p < 0.0001). Interestingly, this benefit was maintained in the over-80s subgroup.
Conclusions
The factors associated with aCT use in the elderly are similar to those usually found in younger age groups. By highlighting an OS benefit, even in the “very old” subgroup, our results may help clarifying the role of aCT in elderly patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Houvenaeghel Gilles.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5793 - Real world treatment sequencing patterns in secondary breast cancer (SBC): Pathway visualisation using national datasets.
Presenter: Ashley Horne
Session: Poster Display session 2
Resources:
Abstract
3185 - Utilization Pattern of Bone Targeting Agents in Patients with Solid Tumor in Taiwan, Hong Kong and Korea
Presenter: Shi Jie Lai
Session: Poster Display session 2
Resources:
Abstract
3705 - Clinico-pathological Features and Prognosis of Patients with Pregnancy Associated Breast Cancer – A Matched Case Control Study
Presenter: Ruyan Zhang
Session: Poster Display session 2
Resources:
Abstract
1421 - TRYbeCA-2: A Randomized Phase 2/3 Study of Eryaspase in Combination with Gemcitabine and Carboplatin Chemotherapy versus Chemotherapy Alone As First-Line Treatment in Patients with Metastatic or Locally Recurrent Triple-Negative Breast Cancer
Presenter: Ahmad Awada
Session: Poster Display session 2
Resources:
Abstract
4119 - CONTESSA TRIO: A Multinational, Multicenter, Phase 2 Study of Tesetaxel plus 3 Different PD-(L)1 Inhibitors in Patients with Metastatic Triple-Negative Breast Cancer (TNBC) and Tesetaxel Monotherapy in Elderly Patients with HER2- Metastatic Breast Cancer (MBC)
Presenter: Sara Tolaney
Session: Poster Display session 2
Resources:
Abstract
4545 - Bintrafusp alfa (M7824) and Eribulin Mesylate in Treating Patients With Metastatic Triple Negative Breast Cancer (TNBC)(NCT03579472)
Presenter: Jennifer Litton
Session: Poster Display session 2
Resources:
Abstract
3340 - Effectiveness of Olaparib Plus Trastuzumab in HER2[+], BRCA–mutated (BRCAm) or Homologous Recombination Deficient (HRD) Advanced Breast Cancer (ABC) patients (pts). The OPHELIA Study
Presenter: José Enrique Alés-Martínez
Session: Poster Display session 2
Resources:
Abstract
1113 - RIBOB : A Study on the efficacy and safety of Ribociclib in combination with letrozole in Older women (≥70 years) with hormone receptor-positive (HR+) HER2-negative (HER2-) advanced Breast cancer (aBC) with no prior systemic therapy for advanced disease
Presenter: Cindy Kenis
Session: Poster Display session 2
Resources:
Abstract
4025 - RIbociclib plus Goserelin with Hormonal Therapy versus physician Choice chemotherapy in premenopausal or perimenopausal patients with HR+, HER2– inoperable locally advanced or metastatic breast cancer – RIGHT Choice study
Presenter: Nagi El Saghir
Session: Poster Display session 2
Resources:
Abstract
3516 - Palbociclib Rechallenge in Hormone Receptor (HR)[+]/HER2[-] Advanced Breast Cancer (ABC). PALMIRA Trial
Presenter: Antonio Llombart Cussac
Session: Poster Display session 2
Resources:
Abstract