Achieving Optimal Dose Intensity with Adjuvant Chemotherapy in Elderly Breast Cancer Patients: A 10-Year Retrospective Study in a UK Institution

93 Background: Women with early-stage TN breast cancers are at increased risk for recurrence (RR) compared to other molecular subtypes, and are often treated with mastectomy without local adjuvant therapy. We wish to evaluate the RR for these women. Methods: In this single institution retrospective study, women with T1-2N0 TN breast cancer who underwent mastectomy between 2008-12 were identified from tumor registry. Adjuvant chemotherapy was allowed, but adjuvant radiotherapy (RT) was excluded. Of 3,000 cases reviewed, 52 women were identified. Median age was 58.5 (30–90). Lesions were high-grade (83%), and T1-2 (47%, 53%). 21 women (42%) had at least 1 risk factor. 5 women were BRCA+. Women underwent total mastectomy or modified radical mastectomy, and the majority (84%) had adjuvant chemotherapy. Results: At a median follow-up of 3.5 years (6-71 months), there were 8 recurrences (15.4%). 3 (5.8% of cohort) were locoregional (LR) only (2 chest wall (CW) and 1 ipsilateral axilla), 6 (11.5%) involved a concurrent LR and distant recurrence, and 2 (3.8%) were distant only. Median time to recurrence was 17.3 months. The isolated LR recurrences (LRR) were at 14, 15.6 and 15.1 months. Most women (41, 78.8%) were alive with NED. 3 were alive with disease, underdoing treatment, and 1 woman was disease free after treatment for CW recurrence. 8 patients (15.4%) are deceased, half from their cancer. On univariate analysis, there was no significant correlation (p>0.05) between age or high-risk features and RR (STATA v 11). Conclusions: T1-2N0 breast cancer patients are believed to have a low RR following mastectomy. TN disease, however, is more aggressive, and the question of irradiating early stage disease after mastectomy has arisen. A single institution, retrospective study found women with T1-2N0 TN disease fare better with BCT that includes RT, compared to mastectomy alone. Other studies have shown no statistical difference in RR between these 2 groups. We found an isolated LRR rate at 3.5 years of 5.8%. Follow-up and ultimately prospective data is needed to determine whether the isolated LRR warrants a change in treatment recommendations for this pt subset.

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Increasing the dose intensity of adjuvant chemotherapy may improve the outcome of node-positive breast cancer patients

The Breast ◽

10.1016/s0960-9776(03)80124-8 ◽

2003 ◽

Vol 12 ◽

pp. S39

Author(s):

E. Del Barco ◽

M.I. Ruiz ◽

C.A. Rodriguez ◽

A. Gomez ◽

P. Sanchez ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Dose Intensity ◽

Breast Cancer Patients ◽

Node Positive ◽

Positive Breast Cancer

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The optimal dose of CAF regimen in adjuvant chemotherapy for breast cancer patients at stage IIB

Mathematical Biosciences ◽

10.1016/j.mbs.2008.04.003 ◽

2008 ◽

Vol 213 (2) ◽

pp. 151-158 ◽

Cited By ~ 9

Author(s):

Hamid Khaloozadeh ◽

Pedram Yazdanbakhsh ◽

Fatemeh Homaei-shandiz

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Optimal Dose ◽

Breast Cancer Patients

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Use of G-CSF to Sustain Dose Intensity in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Pilot Study

Cancer Control ◽

10.1177/107327489600300605 ◽

1996 ◽

Vol 3 (6) ◽

pp. 1-4 ◽

Cited By ~ 18

Author(s):

Jack Webster ◽

Nicole Kuderer ◽

Gary H. Lyman

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Dose Reduction ◽

Cancer Patients ◽

Dose Intensity ◽

Treatment Delay ◽

Breast Cancer Patients ◽

Treatment Delays ◽

Prospective Trials ◽

The Impact

Background Adjuvant chemotherapy for breast cancer is frequently accompanied by neutropenia requiring dose reduction or treatment delay that can potentially compromise therapeutic effectiveness. Recombinant granulocyte-colony stimulating factor (G-CSF) reduces the duration and severity of neutropenia. Methods Nineteen patients with newly diagnosed breast cancer receiving adjuvant systemic chemotherapy met criteria for dose reduction or treatment delay due to neutropenia. All were treated with G-CSF. The mean duration of G-CSF therapy was five days. Results An increase in mean absolute neutrophil count was seen in cycles with G-CSF. Chemotherapy treatment was delayed less often following the use of G-CSF. Conclusions Breast cancer patients receiving adjuvant chemotherapy who face treatment delays or dose reductions can continue on full-dose intensity therapy using supportive G-CSF. Prospective trials are needed to accurately measure the impact of G-CSF on dose intensity and long-term disease control.

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Treatment Pattern and Safety Results of Docetaxel-(Taxotere®)-Based Chemotherapy in Early Breast Cancer Patients in Indonesia: Part of Asia-Pacific Breast Initiative II

Indonesian Journal of Cancer ◽

10.33371/ijoc.v13i1.569 ◽

2019 ◽

Vol 13 (1) ◽

pp. 1

Author(s):

Samuel Johny Haryono ◽

Noorwati Sutandyo ◽

Ramadhan Karsono ◽

Bambang Karsono ◽

Denni Joko Purwanto ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Early Breast Cancer ◽

Dose Intensity ◽

Treatment Pattern ◽

Asia Pacific ◽

Observational Research ◽

Breast Cancer Patients ◽

Total Study Population

Background: Breast cancer is the most diagnosed cancer among Indonesian women. Adjuvant chemotherapy plays a crucial role in the management of early breast cancer patients, with docetaxel-based regimens as a cornerstone therapy. The Asia-Pacific breast initiative II registry was established to evaluate safety parameters of docetaxel-based regimens in the Asia-Pacific region within 2009–2013 period. The result from Indonesia population is presented in this study.Methods: This study was a part of International, longitudinal, multicenter, and observational research which included a group of consecutive early breast cancer patients with an intermediate-to-high risk of recurrence that was being treated with various docetaxel-based (anthracycline and non-anthracycline) adjuvant chemotherapy regimens during 2009–2013 in real-world clinical settings.Results: The analysis included 49 subjects (2.8% of total study population). Majority of subjects received non-anthracycline-containing regimen (79.6%). Docetaxel was mainly prescribed in combination (63.27%). Chemotherapy-related adverse events were reported in all subjects. Mean number of cycles received by subjects was 5.5 cycles with dose intensity of 23.78 mg/m2/week.Conclusions: The Indonesian result, as part of the Asia-Pacific Breast Initiative II Registry, identified some important factors that are relevant to clinical practice, including patient’s characteristics and treatment pattern of docetaxel use as adjuvant chemotherapy regimens.

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