Clinical feasibility of (neo)adjuvant taxane-based chemotherapy in older patients: analysis of >4,500 patients from four German randomized breast cancer trials
2008

Taxane-based chemotherapy for older breast cancer patients

Sample size: 422 publication 10 minutes Evidence: high

Author Information

Author(s): Sibylle Loibl, Gunter von Minckwitz, Nadia Harbeck, Wolfgang Janni, Dirk Elling, Manfred Kaufmann, Holm Eggemann, Valentina Nekljudova, Harald Sommer, Marion Kiechle, Sherko Kümmel

Primary Institution: German Breast Group

Hypothesis

Can taxane-based chemotherapy be safely administered to older breast cancer patients?

Conclusion

Taxane-containing chemotherapy is feasible for older patients, and toxicity can be reduced with sequential therapy regimens.

Supporting Evidence

  • Leucopenia increased from 55.3% in patients aged < 60 years to 65.5% in patients aged > 64 years.
  • Neutropenia increased from 46.9% to 57.4% in older patients.
  • Dose delays and reductions increased with age, indicating higher toxicity in older patients.
  • The combination dose-dense doxorubicin/docetaxel schedule had the highest incidence of hospitalizations.

Takeaway

Older people with breast cancer can safely receive strong chemotherapy, and using certain treatment methods can help reduce side effects.

Methodology

Pooled analysis of side-effect data from four randomized clinical trials involving older patients receiving taxane-based chemotherapy.

Potential Biases

Older patients are often underrepresented in clinical trials, which may skew data on treatment efficacy and safety.

Limitations

The analysis is post hoc, has a relative paucity of patients aged > 70 years, and may not represent older patients with comorbidities.

Participant Demographics

Median age of participants was 67 years, with a range from 65 to 80 years.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/bcr2144

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