Adjuvant chemotherapy for older patients with breast cancer: When is the pain worth the gain?
A partir d'un modèle de simulation, cette étude estime l'intérêt, du point de vue de la réduction de la mortalité, d'ajouter une chimiothérapie adjuvante à un traitement endocrinien chez les patientes atteintes d'un cancer du sein HR+ HER2- de stade précoce et à haut risque de récidive, en fonction de 4 catégories d'âge (65-69 ans, 70-74 ans, 75-79 ans, 80-89 ans) et du niveau de comorbidité
Although many older patients with breast cancer developindolent, early stage diseasewhere chemotherapy is not anticipated to improve survival, a subset have higher-risk disease that is chemotherapy responsive. From the limited data we have available –albeit mostlyfrom registry-based or pooled secondary analyses–patients across the age spectrum derive a consistent relative benefit in breast cancer-specific survival from chemotherapy.1-3Among older women, this apparent benefit is mainlydriven by reducing recurrences in individuals who have low competing risks and high short-termrisksof recurrence. Thebenefit-risk balance is complex in clinical practiceamongolder patientsbecausechemotherapy-induced toxicity is worse,and the benefits are not as well defined as those anticipated inyounger individuals