TNBC: survival is lower for older patients, who tend to forgo chemotherapy

  • Tzikas AK & al.
  • Breast Cancer Res Treat
  • 10 Jun 2020

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

  • In triple-negative breast cancer (TNBC), patients aged >75 years have worse recurrence-free survival (RFS), distant disease-free survival (DDFS), and breast cancer-specific survival (BCSS) than their younger counterparts (aged
  • The survival disadvantages disappeared in this Swedish registry study after the authors controlled for adjuvant/neoadjuvant chemotherapy.

Why this matters

  • The findings suggest that new therapeutic options are needed for older patients because they are not electing chemotherapy.

Study design

  • Analysis of a Swedish regional breast cancer registry data for patients with stage I-IV primary TNBC (2007-2015).
  • Data for patients aged >75 years (n=96) were compared with data for patients aged
  • Funding: King Gustaf V Jubilee Clinic Cancer Research Foundation; others.

Key results

  • Median follow-up, 55 months.
  • Younger vs older patients:
    • Similar stage at diagnosis, lymphovascular invasion.
    • Worse histopathologic grade (P=.006) and Ki67 index (median, 80% vs 70%; P=.002).
    • More likely to receive adjuvant/neoadjuvant chemotherapy (96% vs 12%; P=.0005).
    • More likely to have brain (P=.016) and liver (P=.047) metastases.
  • Compared with younger patients, older patients had worse (HRs; 95% CIs):
    • RFS: 2.22 (1.12-4.43).
    • DDFS: 2.13 (1.07-4.27). 
    • BCSS: 2.78 (1.33-5.81).
  • Differences disappeared after adjustment for receipt of chemotherapy.

Limitations

  • Observational.