Alistair Ring1. 1. Sussex Cancer Centre, Royal Sussex County Hospital, Eastern Road, Brighton, East Sussex BN2 5BE, United Kingdom. Alistair.ring@bsuh.nhs.uk
Abstract
OBJECTIVE: To investigate the influences of age and co-morbidities on the use of adjuvant chemotherapy and trastuzumab in patients with HER2-positive early breast cancer. METHODS: Thirty surgeons and 101 oncologists reviewed the profiles of 16 hypothetical patients which included details of age, tumour size/grade, nodal/ER status, and co-morbidities. Respondents viewed different patient profiles. Oncologists were asked how likely they would be to prescribe chemotherapy ± trastuzumab. Surgeons were asked whether they would refer to an oncologist. RESULTS: Oncologists' treatment decisions were most affected by age and co-morbidities: 81% would prescribe chemotherapy for a high-risk patient aged 68 years, but only 47% for an otherwise identical patient aged 73 years. The majority of surgeons (84%) would still refer older patients. CONCLUSIONS: National variation in the use of adjuvant chemotherapy in women aged ≥70 years with high-risk breast cancer is substantial. Practice audits or clinical trials addressing the outcomes of systemic adjuvant therapy are needed for this ever-increasing population of patients.
OBJECTIVE: To investigate the influences of age and co-morbidities on the use of adjuvant chemotherapy and trastuzumab in patients with HER2-positive early breast cancer. METHODS: Thirty surgeons and 101 oncologists reviewed the profiles of 16 hypothetical patients which included details of age, tumour size/grade, nodal/ER status, and co-morbidities. Respondents viewed different patient profiles. Oncologists were asked how likely they would be to prescribe chemotherapy ± trastuzumab. Surgeons were asked whether they would refer to an oncologist. RESULTS: Oncologists' treatment decisions were most affected by age and co-morbidities: 81% would prescribe chemotherapy for a high-risk patient aged 68 years, but only 47% for an otherwise identical patient aged 73 years. The majority of surgeons (84%) would still refer older patients. CONCLUSIONS: National variation in the use of adjuvant chemotherapy in women aged ≥70 years with high-risk breast cancer is substantial. Practice audits or clinical trials addressing the outcomes of systemic adjuvant therapy are needed for this ever-increasing population of patients.
Authors: Hyman Muss; Javier Cortes; Linda T Vahdat; Fatima Cardoso; Chris Twelves; Jantien Wanders; Corina E Dutcus; Jay Yang; Seth Seegobin; Joyce O'Shaughnessy Journal: Oncologist Date: 2014-03-28
Authors: T Kalsi; G Babic-Illman; P J Ross; N R Maisey; S Hughes; P Fields; F C Martin; Y Wang; D Harari Journal: Br J Cancer Date: 2015-04-14 Impact factor: 7.640
Authors: Maria Burton; Kate J Lifford; Lynda Wyld; Fiona Armitage; Alistair Ring; Anthony Nettleship; Karen Collins; Jenna Morgan; Malcolm W R Reed; Geoffrey R Holmes; Mike Bradburn; Jacqui Gath; Tracy Green; Deirdre Revell; Kate Brain; Adrian Edwards Journal: Trials Date: 2021-07-13 Impact factor: 2.279