Lauren Brown1, Samer A Naffouje2, Christine Sam3, Christine Laronga4, M Catherine Lee5. 1. USF Health Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA. 2. Department of Surgical Oncology, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA. 3. Senior Adult Oncology Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA. 4. Comprehensive Breast Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA. 5. Comprehensive Breast Program, Moffitt Cancer Center, 12902 N. McKinley Drive, Tampa, FL, 33612, USA. marie.lee@moffitt.org.
Abstract
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.
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.
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: Carol E DeSantis; Jiemin Ma; Mia M Gaudet; Lisa A Newman; Kimberly D Miller; Ann Goding Sauer; Ahmedin Jemal; Rebecca L Siegel Journal: CA Cancer J Clin Date: 2019-10-02 Impact factor: 508.702
Authors: Mandy Kiderlen; Nienke A de Glas; Esther Bastiaannet; Willemien van de Water; Anton J M de Craen; Onno R Guicherit; Jos W S Merkus; Martine Extermann; Cornelis J H van de Velde; Gerrit-Jan Liefers Journal: Breast Cancer Res Treat Date: 2014-03-28 Impact factor: 4.872
Authors: Jennifer L Patnaik; Tim Byers; Carolyn Diguiseppi; Thomas D Denberg; Dana Dabelea Journal: J Natl Cancer Inst Date: 2011-06-30 Impact factor: 13.506