Survival and time to initiation of adjuvant chemotherapy among breast cancer patients: a systematic review and meta-analysis

Zhan, Qiao; Fu, Jian; Fu, Fang; Zhang, Jie; Wang, Chuan

doi:10.18632/oncotarget.23086

Cited by 42 publications

(52 citation statements)

References 40 publications

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“…Time to adjuvant chemotherapy was analysed with three different cut‐off values: within 6 weeks or after more than 6 weeks, within 9 weeks or after more than 9 weeks, and within 12 weeks or after more than 12 weeks. These cut‐offs were chosen based on the currently recommended starting point according to Dutch and ESMO guidelines, and on previous literature demonstrating that a clinical impact is found when adjuvant chemotherapy is started later than 7–12 weeks, indicating the importance of initiating adjuvant chemotherapy at least within this time period.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have reported that delayed initiation of adjuvant chemotherapy is associated with lower overall and recurrence‐free survival. The recommended acceptable maximum delay, however, varies from 7 to 12 weeks.…”

Section: Introductionmentioning

confidence: 99%

“…The recommended acceptable maximum delay, however, varies from 7 to 12 weeks. There still is no international consensus on the definition of an unacceptable delay, but all guidelines advocate that initiation of adjuvant chemotherapy should not be delayed unnecessarily, as this may have a negative impact on survival, specifically in patients at higher risk of recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

Heeg

Harmeling

Becherer

et al. 2019

British Journal of Surgery

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Background: Initiation of adjuvant chemotherapy within 6-12 weeks after mastectomy is recommended by guidelines. The aim of this population-based study was to investigate whether immediate breast reconstruction (IBR) after mastectomy reduces the likelihood of timely initiation of adjuvant chemotherapy.Methods: All patients with breast cancer who had undergone mastectomy and adjuvant chemotherapy between 2012 and 2016 in the Netherlands were identified. Time from surgery to adjuvant chemotherapy was categorized as within 6 weeks or after more than 6 weeks, within 9 weeks or after more than 9 weeks, and within 12 weeks or after more than 12 weeks. The impact of IBR on the initiation of adjuvant chemotherapy for these three scenarios was estimated using propensity score matching to adjust for treatment by indication bias.Results: A total of 6300 patients had undergone primary mastectomy and adjuvant chemotherapy, of whom 1700 (27⋅0 per cent) had received IBR. Multivariable analysis revealed that IBR reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks (odds ratio (OR) 0⋅76, 95 per cent c.i. 0⋅66 to 0⋅87) and 9 weeks (0⋅69, 0⋅54 to 0⋅87), but not within 12 weeks (OR 0⋅75, 0⋅48 to 1⋅17). Following propensity score matching, IBR only reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks (OR 0⋅95, 0⋅90 to 0⋅99), but not within 9 weeks (OR 0⋅97, 0⋅95 to 1⋅00) or 12 weeks (OR 1⋅00, 0⋅99 to 1⋅01).Conclusion: Postmastectomy IBR marginally reduced the likelihood of receiving adjuvant chemotherapy within 6 weeks, but not within 9 or 12 weeks. Thus, IBR is not contraindicated in patients who need adjuvant chemotherapy after mastectomy.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

Heeg

Harmeling

Becherer

et al. 2019

British Journal of Surgery

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“…Treatment of CMTs is currently limited to surgical removal, as therapy with anticancer drugs has proved largely inadequate . As efficient chemotherapy decreases the risk of breast cancer recurrence and mortality in human patients, an appropriate chemotherapeutic agent might also improve clinical outcomes of tumour resections in dogs. Using CMT cell lines P114 and CF41, we tested whether Palbociclib, a CDK4/6 inhibitor recently approved for treating advanced, ER‐positive mammary tumours in human patients, may represent a candidate for treating CMTs.…”

Section: Discussionmentioning

confidence: 99%

In vitro study to assess the efficacy of CDK4/6 inhibitor Palbociclib (PD‐0332991) for treating canine mammary tumours

Schoos

Knab

Gabriel

et al. 2019

Vet Comparative Oncology

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Therapy of canine mammary tumours (CMTs) with classical antitumour drugs is problematic, so better therapeutic options are needed. Palbociclib (PD-0332991) is an innovative and effective anticancer drug for the treatment of breast cancer in women. Palbociclib is an inhibitor of cyclin-dependent kinase 4 (CDK4) and CDK6, which are key regulators of the cell cycle machinery and thus cell proliferation. In the present in vitro study, we investigated whether Palbociclib also represents a candidate drug to combat CMT. For this purpose, the effect of Palbociclib was analysed in P114 and CF41 cells, two CMT cell lines with an endogenous CDK4/6 co-expression. Incubation of P114 and CF41 cells with Palbociclib resulted in a dose-and timedependent loss of phosphorylated retinoblastoma protein (pRb), a classical CDK4/6 substrate within the cell cycle machinery. Moreover, treatment of CMT cells with Palbociclib-induced cell cycle arrest affected cell viability, prevented colony formation and impaired cell migration activity. Palbociclib also inhibited the growth of P114 and CF41 cell spheroids. Immunohistochemical analysis of canine patient samples revealed a consistent expression of CDK6 in different canine mammary carcinoma types, but an individual and tumour-specific expression pattern of phosphorylated pRb independent of the tumour grade. Together, our findings let us suggest that Palbociclib has antitumour effects on CMT cells and that canine patients may represent potential candidates for treatment with this CDK4/6 inhibitor. K E Y W O R D S canine mammary tumour, CDK4/6, cell cycle, migration, Palbociclib

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“…Some clinical studies suggest that an adjuvant chemotherapy delay for up to 12 weeks will significantly reduce the effectiveness of systemic therapy. Results of meta-analyses show that OS decreases by 13% and DFS by 14% every four weeks that adjuvant chemotherapy is delayed [28].…”

Section: Discussionmentioning

confidence: 99%

Optimal time for adjuvant therapy initiation in breast cancer patients: A single center experience

et al. 2018

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Introduction. This retrospective study evaluates the association between the time of chemotherapy initiation and disease free survival in regard to breast cancer subtypes and stage at diagnosis. Material and Methods. The study included a total of 1075 breast cancer patients, stages I -III, treated at Oncology Institute of Vojvodina, Serbia (from 2010 to 2012; n = 617). The gathered data included prognostic factors used in everyday practice. Patients were divided into three groups according to the interval between surgery and chemotherapy (≤ 30, 31 -60, ≥ 61 days). Disease free survival was calculated. Results. Among the 617 patients, the 5-year disease free survival estimate was similar: 81.5%, 81.0%, 84.6% (log-rank test, p = 0.728) regarding the time of adjuvant chemotherapy initiation: ≤ 30 days, 31 -60, and ≥ 61 days, respectively. The study showed that 85% of our breast cancer patients started adjuvant chemotherapy within 3 months after definitive surgery. In multivariate analysis, independent prognostic factors for disease free survival were nodal status and tumor size. The 5-year disease free survival estimate was 85.8% (p = 0.001) for patients with luminal-A subtype (Estrogen +, Progesterone high, human epidermal growth factor receptor 2 ̶ , Ki-67 < 20%) with a median follow-up of 62,7 months; for patients with luminal-B (Luminal B (human epidermal growth factor receptor 2 -) Estrogen +, human epidermal growth factor receptor 2 ̶ , either Ki-67 high or Progesterone low, Luminal B (human epidermal growth factor receptor +) Estrogen +, human epidermal growth factor receptor 2 +, any Ki-67, any Progesterone) 78.3% (p = 0.534) with a median follow-up of 55.9 months; for patients with triple negative breast cancer it was 73.4% with a median follow-up of 58,1 months, and for patients with human epidermal growth factor receptor 2+ it was 77.1% (p = 0.448) with a median follow-up of 55.5 months. Conclusion. Early initiation of adjuvant chemotherapy is particularly important in patients with advanced-stage breast cancer at diagnosis, and those with trastuzumab-treated triple-negative breast cancer and human epidermal growth factor receptor 2-positive tumors. SažetakUvod. Ova retrospektivna studija ispituje uticaj vremena započinjanja hemioterapije na dužinu vremena bez progresije bolesti u zavisnosti od tipa karcinoma dojke i stadijuma u momentu dijagnoze. Materijal i metode. U studiji je obuhvaćeno 1 075 pacijenata obolelih od karcinoma dojke, stadijum bolesti I-III, lečenih na Institutu za onkologiju Vojvodine, Srbija (od 2010. do 2012. godine, n = 617). Podaci su prikupljeni u odnosu na prognostičke faktore korišćene u svakodnevnoj praksi. Pacijenti su podeljeni u tri grupe shodno vremenu započinjanja hemioterapije nakon definitivne hirurgije (≤ 30, 31 do 60, ≥ 61 dan). Period bez bolesti je takođe izračunat. Rezultati. Među 617 pacijenata koji su bili uključeni, petogodišnji period bez bolesti bio je redom 81,5%, 81%, 84,6% (log -rank test p = 0,728), među pacijentima koji su započeli hemioterapiju ≤ 30, 31 do...

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Survival and time to initiation of adjuvant chemotherapy among breast cancer patients: a systematic review and meta-analysis

Cited by 42 publications

References 40 publications

Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

Nationwide population-based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

In vitro study to assess the efficacy of CDK4/6 inhibitor Palbociclib (PD‐0332991) for treating canine mammary tumours

Optimal time for adjuvant therapy initiation in breast cancer patients: A single center experience

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