Acute toxicity and tolerability of anthracycline-based chemotherapy regimens in older versus younger patients with breas
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ORIGINAL ARTICLE
Acute toxicity and tolerability of anthracycline-based chemotherapy regimens in older versus younger patients with breast cancer: real-world data Ana Raquel Monteiro 1 & Ana Rita Garcia 1 & Sara Póvoa 1 & Rita Félix Soares 1 & Filipa Macedo 1 & Tatiana Cunha Pereira 1 & Isabel Domingues 1 & Isabel Pazos 1 & Gabriela Sousa 1 Received: 6 June 2020 / Accepted: 8 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To compare the non-cardiac acute toxicity and tolerability profile of anthracycline-based regimens between older versus younger women diagnosed with breast cancer in a real-world setting. Methods Retrospective cohort of female patients diagnosed with breast cancer and treated with neoadjuvant or adjuvant anthracycline-based regimens between 2017 and 2019. Patients were grouped in young versus older, using an age of 65 as cut-off. Differences in non-cardiac acute toxicity and change in treatment plan were examined. Results Among the 559 patients, 19.5% were aged ≥ 65 years. Regimens used were fluorouracil, epirubicin, and cyclophosphamide in 56.2% of patients, doxorubicin and cyclophosphamide in 33.3%, and epirubicin and cyclophosphamide in 10.5%; there were no differences in incidence of grade 3 or 4 toxicities between regimens (p = 0.184). Acute grade 3 or 4 toxicities occurred more frequently in the older group (33.9% versus 10.7%, p < 0.0001, OR 4.304, 95%-CI [2.619–7.073]). Delay of at least one chemotherapy cycle due to toxicity occurred more frequently in the older group (24.8% versus 9.3%, p < 0.0001, OR 3.199, 95%-CI [1.867–5.481]). Early termination of treatment also occurred more frequently in the older group (11.9% versus 1.6%, p < 0.0001, OR 8.571, 95%-CI [3.331–22.048]). Conclusion Although acute grade 3 or 4 toxicities were more frequent in older patients, which resulted in increased cycle delay and/or premature termination of treatment, overall treatment was still reasonably well-tolerated, with 88.1% of older patients completing the planed anthracycline regimen. Keywords Breast cancer . Older patients . Anthracyclines . Neoadjuvant chemotherapy . Adjuvant chemotherapy . Toxicity
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05766-6) contains supplementary material, which is available to authorized users. * Ana Raquel Monteiro [email protected]
Tatiana Cunha Pereira [email protected] Isabel Domingues [email protected]
Ana Rita Garcia [email protected]
Isabel Pazos [email protected]
Sara Póvoa [email protected]
Gabriela Sousa [email protected]
Rita Félix Soares [email protected] 1
Filipa Macedo [email protected]
Medical Oncology Department, Portuguese Oncology Institute of Coimbra Francisco Gentil, Av. Bissaya Barreto 98, 3000-075 Coimbra, Portugal
Support Care Cancer
Introduction
Materials and methods
Breast cancer is a frequent malignancy occurring in women of all ages. However, over 40% of wome
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