Outcome and feasibility of palliative chemotherapy in very elderly patients with metastatic breast cancer

Abstract

In the Netherlands, approximately 1300 women aged ≥75 years die every year of metastatic breast cancer (MBC). Data on palliative chemotherapy (CT) in very elderly patients are rare, and prospective studies appeared cumbersome. Therefore, we retrospectively analyzed the outcome and feasibility of chemotherapy in elderly MBC patients. Records of all patients with MBC aged ≥75 years who received first‐line palliative chemotherapy between January 2000 and December 2014 at two large teaching hospitals in the Netherlands were reviewed. We registered patient and tumor characteristics together with data on previous adjuvant treatment, palliative endocrine treatment, comorbidities, clinical benefit (defined as ≥6 months progression‐free survival), toxicity, and the reason for stopping chemotherapy. Patients with progressive disease (PD) or death within 30 days after starting CT were censored from analysis. A total of 54 patients with a median age of 77.6 years (range 75‐90) were treated with palliative chemotherapy for MBC. Of them, 20 patients (37%) were aged ≥ 80 years. There was clinical benefit in 28 patients (52%). Median progression‐free survival and median overall survival were 6.0 and 14.0 months, respectively. One year after the diagnosis of MBC, 27 patients (50%) were still alive and 15 patients (28%) lived longer than 2 years. Reasons for stopping CT were progressive disease (n = 32) or toxicity (n = 13). Most patients (n = 48) died of MBC while two patients died of toxicity. In selected patients with MBC aged 75 years or older, single‐agent palliative chemotherapy is feasible and may have clinical benefit.

Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients

“…Generally, data on palliative chemotherapy (CHT) in very elderly patients are rare: in a recently published paper, Overgaauw et Al. retrieved clinical records of patients older than 75 years who received first-line chemotherapy in 2 large teaching hospitals in The Netherlands between 2000 and 2014, finding only 54 evaluable patients 22 Other different studies on palliative therapy in very elderly patients reported similar difficulties in enrolling this population 23 .…”

Análise De Toxicidade Em Pacientes Oncogeriátricos Atendidos No Hospital Universitário São Francisco Na Providência De Deus

“…A disparidade nos graus de toxicidade, bem como a demanda por reduções de dose, convida à reflexão sobre a necessidade de integrar uma visão mais holística na oncologia geriátrica. O envolvimento de uma equipe multidisciplinar, que possa abordar não apenas os desafios médicos, mas também os sociais e psicológicos enfrentados por pacientes idosos, surge como uma estratégia que pode aprimorar a qualidade e a eficácia da gestão do cuidado oncológico nesta população (KRZYZANOWSKA et al, 2021;OVERGAAUW et al, 2020).…”

Preventing metastatic emergence of breast cancer

“…These cancers can re-emerge as lethal metastases even decades after the initial tumor appears to have been curatively resected, as the breast cancer cells can escape the local tumor, seed distant organs, and become chemo-resistant even before being detected, making targeting of dissemination impractical [ 1 ]. To prolong survival, metastatic breast cancers require intensive and debilitating therapies that are poorly tolerated in the elderly [ 2 ]. Thus, well-tolerated regimens are desirable to forestall or even prevent these recurrent breast cancers.…”