A retrospective study of the impact of age on patterns of care for elderly patients with metastatic breast cancer

Abstract

This study aims at evaluating the impact of age on patterns of care in elderly patients with metastatic breast cancer (MBC) and their outcome. We identified 177 patients aged ≥ 65 treated for MBC at the National Cancer Center Hospital in Japan from 1999 to 2007. We evaluated the impact of age on the selection of best supportive care (BSC) only, chemotherapy as first-line treatment, and chemotherapy after first-line endocrine therapy. Fisher's exact test and a multivariate logistic regression analysis with variables of age, performance status (PS), hormone receptor (HR) status, human epidermal growth factor-2 (HER2), and life-threatening disease (LTD) were used. The median age of patients was 72, and 60 patients (33.9%) were aged ≥ 75. HR-negative patients and those whose PS was ≥ 2, regardless of age, were more likely to choose BSC without chemotherapy. Multivariate analysis revealed age ≥ 75 (P = 0.018), positive-HR status (P < 0.001), and absence of LTD (P < 0.001) were significantly correlated to choose endocrine therapy rather than chemotherapy. In patients who had previous endocrine therapy, age (P = 0.008) and absence of HER2 (P = 0.018) were related not to choose chemotherapy. Not age but HR-negative status or PS ≥ 2 were related to the selection of BSC. In selecting endocrine therapy rather than chemotherapy, age (≥ 75), HR-positive, and absence of LTD were significant factors. In patients failed to endocrine therapy, age and HER2 status were correlated to decision-making to choose chemotherapy.

TREX2 Exonuclease Causes Spontaneous Mutations and Stress-Induced Replication Fork Defects in Cells Expressing RAD51K133A

“…RF maintenance is critical for preserving genome integrity. As a part of RF maintenance, BRCA2 and other recombination mediators assemble the RAD51 filament (Krejci et al, 2012;San Filippo et al, 2006;Sigurdsson et al, 2001) to suppresses nucleolytic degradation and promote fork reversal and restart (Hashimoto et al, 2010;Kondratova et al, 2015;Mijic et al, 2017;Schlacher et al, 2011). PARP1 inhibits RECQ1 helicase to stabilize RRFs (Berti et al, 2013;Sogo et al, 2002).…”

“…It also forms a filament at gaps associated with RFs not coupled with DSBs (Sirbu et al, 2011). RAD51 protects stalled RFs from MRE11-mediated nucleolytic degradation and promotes fork reversal and restart, thereby maintaining continuous DNA synthesis (Hashimoto et al, 2010;Kondratova et al, 2015;Mijic et al, 2017;Schlacher et al, 2011). The Walker A motif in RAD51 contains a conserved K that binds and hydrolyses ATP.…”

Treatment Patterns and Outcomes in Elderly Patients with Metastatic Breast Cancer: A Multicenter Retrospective Study

“…In addition, age was one of the most important deciding factors in the selection of chemotherapy (versus hormonal therapy) as first-line treatment among HR-positive patients; the OR for receiving chemotherapy in the group ≥75 years in comparison to the group aged 65 to 69 years was 0.010 ( p =0.006). Age has already been reported to be a significant factor related to treatment selection in elderly patients with MBC [ 15 17 ].…”

Ability of the Comprehensive Geriatric Assessment to Predict Frailty in Older People Diagnosed with Cancer in a General Hospital

“…In the field of oncogeriatrics, distinguishing the frail elderly may influence subsequent decision-making. [16][17][18][19] This work was carried out to identify which demographic factors and/or which elements of the CGA allowed prediction of the risk of frailty as measured by the BQ. The only factors that have been found to act as predictors of the risk of frailty are age, marital status (unmarried) and dependence in IADL.…”