Αρχική World News Risk Tool Predicts Severe Chemotherapy Toxicity in Elderly Patients with Early Breast...

Risk Tool Predicts Severe Chemotherapy Toxicity in Elderly Patients with Early Breast Cancer

Allison Magnuson of the University of Rochester in Rochester, NY, US and colleagues reported on 14 January 2021 in the Journal of Clinical Oncology that the Cancer and Aging Research Group-Breast Cancer score, which they derived by combining eight clinical and geriatric variables, was developed to classify elderly patients with early breast cancer into low, intermediate, and high risk for developing grade 3-5 chemotherapy toxicity. The score was externally validated and demonstrated that better predicts toxicity compared with prior models and physician-rated performance status. It was also strongly associated with dose reductions, dose delays, early treatment discontinuation, reduced dose intensity, and hospitalisations.

The authors commented in the study background that limited tools exist to predict the risk of chemotherapy toxicity in elderly patients with early breast cancer. Karnofsky performance status or Eastern Cooperative Oncology Group performance status, were developed and validated in younger patients but do not reliably assess the fitness of older patients. Existing toxicity prediction models were developed and validated in a heterogeneous elderly population with various cancer subtypes, stages, and chemotherapy regimens. They underlined that a tool that accounts for specific disease and treatment variables that are relevant for elderly patients with early breast cancer may provide more accurate risk estimates.

The authors conducted a multicentre, prospective cohort study of elderly patients with early breast cancer who were initiating adjuvant or neoadjuvant chemotherapy. The main objective was to develop and validate a model to predict grade 3-5 chemotherapy toxicity in elderly patients with early breast cancer.

Patients of age ≥65 years with stage I-III breast cancer from 16 institutions treated with neoadjuvant or adjuvant chemotherapy were prospectively evaluated for geriatric and clinical features predictive of grade 3-5 chemotherapy toxicity. Logistic regression with best-subsets selection was used to identify and incorporate independent predictors of toxicity into a model with weighted variable scoring. Model performance was evaluated using area under the ROC curve (AUC) and goodness-of-fit statistics. The model was internally and externally validated.

In 473 patients of whom 283 in development and 190 in validation cohort, 46% developed grade 3-5 chemotherapy toxicities. Eight independent predictors were identified and each assigned weighted points: 1 point  for anthracycline use, 3 points for stage II or III, 4 points for planned treatment duration >3 months, 3 points for abnormal liver function, 3 points for low haemoglobin, 4 points for falls, 3 points for limited walking, and 3 points for lack of social support.

The study team calculated risk scores for each patient and defined three risk groups: low in case of 0-5 points, intermediate in case of 6-11 points, or high in case of ≥12 points. In the development cohort, the rates of grade 3-5 chemotherapy toxicity for these three groups were 19%, 54%, and 87%, respectively (p < 0.01). In the validation cohort, the corresponding toxicity rates were 27%, 45%, and 76%. The AUC was 0.75 (95% confidence interval [CI] 0.70 to 0.81) in the development cohort and 0.69 (95% CI 0.62 to 0.77) in the validation cohort.

Risk groups were also associated with hospitalisations and reduced dose intensity (p < 0.01).

The authors commented that their findings may be useful to clinicians for predicting individual probability of chemotherapy toxicity and directing therapy in elderly patients with early breast cancer. Intensifying supportive care and developing modified treatment regimens may be appropriate for subgroups identified as being vulnerable to greater toxicity. 


Magnuson A, Sedrak MS, Gross CP, et al. Development and Validation of a Risk Tool for Predicting Severe Toxicity in Older Adults Receiving Chemotherapy for Early-Stage Breast Cancer. Journal of Clinical Oncology; Published online 14 January 2021. DOI: 10.1200/JCO.20.02063.



Συμπληρώστε το email σας για να λαμβάνετε τις σημαντικότερες ειδήσεις από το ogkologos.com

Βρείτε μας

2,449ΥποστηρικτέςΚάντε Like

Διαβαστε Επίσης


Η Παγκόσμια Ημέρα Κατά του Καρκίνου καθιερώθηκε με πρωτοβουλία της Διεθνούς Ένωσης κατά του Καρκίνου (UICC), που εκπροσωπεί 800 οργανώσεις σε 155 χώρες του...


ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ) Γράφει ο Δρ Παπαδούρης Σάββας, Παθόλογος-Ογκολόγος   Ο ΜΜΚΠ βρίσκεται αναλογικά στο 80% και πλέον του συνολικού...

Διατρέχουν όντως οι καρκινοπαθείς μεγαλύτερο κίνδυνο λόγω κοροναϊού;

Σε πρακτικό επίπεδο, τα δεδομένα των σχετικών μελετών υποδηλώνουν ότι η χημειοθεραπεία ή οι άλλες αντι-νεοπλασματικές θεραπείες δεν αυξάνουν σημαντικά τον κίνδυνο θνησιμότητας από...

FDA: Η ακτινοβολία των smartphones δεν προκαλεί καρκίνο

Σε μια νέα έκθεσή της, η Υπηρεσία Τροφίμων και Φαρμάκων (FDA) των ΗΠΑ αναφέρει ότι επανεξέτασε τις σχετικές επιστημονικές έρευνες που δημοσιεύθηκαν τα τελευταία...

Νέα ανακάλυψη, νέα ελπίδα για τον καρκίνο

Ένα νεοανακαλυφθέν τμήμα του ανοσοποιητικού μας συστήματος θα μπορούσε να αξιοποιηθεί για την αντιμετώπιση όλων των ειδών καρκίνου, σύμφωνα με επιστήμονες του πανεπιστημίου Cardiff...

Καρκίνος: Ευεργετική για τους καρκινοπαθείς η άσκηση

Σημαντικά ωφέλη προσφέρει η άσκηση, ακόμη και σε ασθενείς με καρκίνο. Οι περισσότεροι ασθενείς αγνοούν τα οφέλη που μπορεί να έχει γι’ αυτούς η συχνή...
- Advertisment -

Ροή Ειδήσεων

EMA Recommends Granting a Conditional Marketing Authorisation for Dostarlimab

On 25 February 2021, the European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting...

Rare Disease Day: Raising Awareness for Rare Cancers

Every year on the last day of February, the world recognizes rare diseases—a day now known as Rare Disease Day. Rare diseases affect approximately 25...

Oncotype DX Breast Cancer Test May Be Less Accurate for Black Patients

February 26, 2021, by NCI Staff A sample of an Oncotype DX Breast Recurrence Score report. Credit: Adapted from image provided courtesy of Genomic Health The Oncotype...

Increase in Node-Positive and Stage III Breast Cancer After Two Months Screening Interruption Due to COVID-19 Pandemic

An increase in node-positive and stage III breast cancer after two months interruption in breast cancer screening due to COVID-19 pandemic was reported by...

Breast Cancer Survivor Opens Her Own Business 17 Years After Beating the Disease

The height of the pandemic may not be everyone’s ideal time to try and open a business. With restrictions limiting consumerism and Americans across...

The Late Alex Trebek’s Wardrobe Is Being Given to Homeless Men and Former Inmates

Alex Trebek, the late host of Jeopardy!, passed away on November 8th, 2020, at the age of 80, after a battle with pancreatic cancer....