HR+ node+ early breast cancer: older patients benefit less from German guideline-concordant chemo

  • Taubenhansl C & al.
  • Arch Gynecol Obstet
  • 20 Nov 2019

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

  • Guideline-concordant chemotherapy is of no to minimal survival benefit for patients ≥70 years with hormone receptor (HR)-positive, node-positive invasive early breast cancer, according to a cohort study from Germany.
  • Across patients of all ages, there was an OS and distant metastasis-free benefit (DMFS).

Why this matters

  • Older patients should be informed of the minimal benefit weighed against the risks of chemotherapy.

Study design

  • Population-based, retrospective cohort from Regensburg, Germany, comparing patients who received S3 Guideline-concordant chemotherapy (n=1544) vs no chemotherapy (n=228).
  • Funding: None disclosed.

Key results

  • Median follow-up, 6.4 years.
  • Across all ages, chemotherapy was associated with better 5-year OS (91.3% after chemotherapy vs 76.8% after no chemotherapy; P<.001 and dmfs vs respectively p>
  • Subgroup analysis of patients ≥70 years found that chemotherapy was associated with minimally better 5-year OS (75.4% vs 72.6%; P=.038), but no better DMFS (74.0% vs 71.4%; P=.112).
  • Subgroup analysis of patients
  • Multivariate analysis confirmed all findings, except it failed to find any benefit in 5-year OS in patients ≥70 years (P=.242).
  • Limitations

    • Missing information on nononcological comorbidities.