Breast cancer: NACT delay does not appear to affect survival

  • Livingston-Rosanoff D & al.
  • Breast J
  • 12 Sep 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Delays in beginning neoadjuvant chemotherapy (NACT) did not adversely affect OS in women with stages I-III triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive breast cancer.

Why this matters

  • This is the first study of the effect of time to initiation of NACT and long-term outcome.
  • Results are reassuring to patients with aggressive disease who delay NACT up to 6 months after diagnosis.

Study design

  • Retrospective cohort (n=12,806) of women with stage I-III breast cancer in the US National Cancer Database.
  • Patients with hormone receptor (HR)-positive/HER2- disease were excluded because of lower NACT use and better prognosis.
  • Funding: None disclosed.

Key results

  • Breast cancer subtypes included TNBC (50%), HR+/HER2+ disease (30%), and HR/HER2+ disease (20%).
  • Median time from diagnosis to NACT was 4.3 (range, 0-25.6) weeks.
  • Median follow-up was 36 months.
  • When time to NACT initiation was a continuous variable, no relationship was found between OS and TNBC (HR, 1.00; P=.71) or HER2+ cancer (HR, 0.98; P=.26).
  • When time to NACT initiation was dichotomized, no relationship was found between OS and:
    • Delay >4 weeks (vs + disease (HR, 0.91; P=.37).
    • Delay >3 weeks (vs

Limitations

  • Retrospective, observational design.