Older age and comorbidity in breast cancer: is RT alone the new therapeutic frontier?

Rocca, Eliana La; Meneghini, Elisabetta; Lozza, Laura; Fiorentino, Alba; Vitullo, Angelo; Giandini, Carlotta; Bonfantini, F.; Cosimo, Serena Di; Gennaro, Massimiliano; Sant, Milena; Pignoli, E.; Valdagni, Riccardo; Santis, Maria Carmen De

doi:10.1007/s00432-020-03243-5

Cited by 7 publications

(6 citation statements)

References 36 publications

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“… 26 Another novel reported finding in the BC patients ≥80 years is that those patients discontinued the prescribed therapy earlier and more frequently than younger patients. 27 , 28 The comprehensive influence of factors may result in the worse prognosis of octogenarian patients. Another prognostic demographic variable is race, which has been widely reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Prognostic Nomogram for Elderly Breast Cancer: A Large-Cohort Retrospective Study

Li¹,

Zhang²

2022

IJGM

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Purpose: Our research aims to study the bone metastatic patterns and prognostic outcomes in elderly breast cancer (BC) and to develop elder-specific nomograms. Methods: We downloaded the data of BC patients between 2010 and 2016 from the Surveillance, Epidemiology, and End Results database. The differences in clinical features and prognosis between young (age < 65) and elderly (age ≥ 65) BC patients were compared. The univariate and multivariate Cox analyses were used to determine the overall survival (OS)-and cancer-specific survival (CSS)-related variables and establish two nomograms of BC patients with bone metastasis (BCBM). The receiver operating characteristic (ROC) curve with area under the curve (AUC), calibration curve, decision curve analysis (DCA), and Kaplan-Meier survival curve were selected to evaluate nomograms. Results: A total of 230,177 BC patients were enrolled in our research, including 142,025 young and 88,152 elderly patients. The prognosis of elderly BCBM patients was significantly worse than young patients. Age, race, breast subtype, tumor size, tumor grade, brain metastasis, liver metastasis, surgery, and chemotherapy were independent prognostic variables for elderly BCBM patients, including OS and CSS. The AUC values at 12, 18, and 24 months were 0.750, 0.751, and 0.739 for OS nomogram and 0.759, 0.762, and 0.752 for CSS nomogram in the training cohort, which were higher than the AUC values of all single independent prognostic variables. The survival curve showed a distinct prognosis between low-, median-and high-risk groups (p < 0.001). Finally, calibration curves and DCA indicated that both nomograms have favorable performance. Conclusion:Elderly and young patients presented with different bone metastatic frequencies, clinical features, and prognostic outcomes. Two elder-specific nomograms incorporating nine clinical variables were established and validated to be a valuable predictor for elderly BCBM patients.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of Prognostic Nomogram for Elderly Breast Cancer: A Large-Cohort Retrospective Study

Li¹,

Zhang²

2022

IJGM

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“…Despite the high utilisation of endocrine therapy in older patients, multiple studies suggest non-adherence increases with increasing age, possibly owing to the susceptibility of older patients to systemic toxicity. 84 , 85 In accordance with EUSOMA–SIOG, a crucial condition preceding the use of endocrine therapy should be a discussion about adherence to treatment and close monitoring of side-effects that might preclude long-term use. 24 Interestingly, locoregional recurrence is reported to increase with endocrine therapy discontinuation, 85 but discontinuation was not associated with a concomitant effect on overall survival or progression-free survival.…”

Section: Clinical Trends In De-implementation In Low-risk Breast Cancer In Older Womenmentioning

confidence: 99%

“… 84 , 85 In accordance with EUSOMA–SIOG, a crucial condition preceding the use of endocrine therapy should be a discussion about adherence to treatment and close monitoring of side-effects that might preclude long-term use. 24 Interestingly, locoregional recurrence is reported to increase with endocrine therapy discontinuation, 85 but discontinuation was not associated with a concomitant effect on overall survival or progression-free survival. 84 , 85 In the CALGB 9343 trial of breast-conserving surgical procedures with subsequent radiation, older patients who adhered to endocrine therapy had lower cancer recurrence and higher overall survival, but equivalent cancer-specific mortality, than did older patients who did not adhere to endocrine therapy.…”

Section: Clinical Trends In De-implementation In Low-risk Breast Cancer In Older Womenmentioning

confidence: 99%

Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women

Carleton

Nasrazadani

Gade

et al. 2022

The Lancet Healthy Longevity

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Age is one of the most important risk factors for the development of breast cancer. Nearly a third of all breast cancer cases occur in older women (aged ≥70 years), with most cases being oestrogen receptor-positive (ER+). Such tumours are often indolent and unlikely to be the ultimate cause of death for older women, particularly when considering other comorbidities. This Review focuses on unique clinical considerations for screening, detection, and treatment regimens for older women who develop ER+ breast cancers—specifically, we focus on recent trends for de-implementation of screening, staging, surgery, and adjuvant therapies along the continuum of care. Additionally, we also review emerging basic and translational research that will further uncover the unique underlying biology of these tumours, which develop in the context of systemic age-related inflammation and changing hormone profiles. With prevailing trends of clinical de-implementation, new insights into mechanistic biology might provide an opportunity for precision medicine approaches to treat patients with well tolerated, low-toxicity agents to extend patients’ lives with a higher quality of life, prevent tumour recurrences, and reduce cancer-related burdens.

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“…Breast cancer is a significant illness, with 1.41 million new diagnoses and 46,000 fatalities occurring each year (Oeffinger et al, 2015;La Rocca et al, 2020). Breast cancer has a high rate of morbidity and mortality and is the second leading cause of death in women (Pagani et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Impact of B-Glucan Against Ehrlich Ascites Carcinoma Induced Renal Toxicity in Mice

Hasan¹,

Alankooshi²,

Abbood³

et al. 2023

OnLine Journal of Biological Sciences

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Several studies have been focused on identifying alternative medicines for the treatment of cancer. This study aimed to investigate the impact of B-Glucans extract (BG) against Ehrlich Ascites Carcinoma (EAC) induced toxicity and tissue damage in kidney. A total of 40 mice were assigned randomly to four groups (G1, control; G2, B-Glucans (75 mg/kg bw/day) orally for 2 weeks; G3, EAC and G4, EAC + BG). Current results revealed, EAC induced significant elevation in urea, creatinine, potassium (k + ), chloride (Cl -) ions, kidney injury and significant decrease in sodium (Na + ) and calcium (Ca ++ ) ions when compared to B-glucans and control groups. Conversely, EAC + B-glucans modulate these changes and improved the renal functions and structure. EAC induced renal dysfunction and B-Glucans has the ability to improve renal functions. We can conclude that; BG could be used as an adjuvant therapy for kidney in ascites of hepatocellular carcinoma, Schistosoma and hepatitis.

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Older age and comorbidity in breast cancer: is RT alone the new therapeutic frontier?

Cited by 7 publications

References 36 publications

Development and Validation of Prognostic Nomogram for Elderly Breast Cancer: A Large-Cohort Retrospective Study

Development and Validation of Prognostic Nomogram for Elderly Breast Cancer: A Large-Cohort Retrospective Study

Personalising therapy for early-stage oestrogen receptor-positive breast cancer in older women

Impact of B-Glucan Against Ehrlich Ascites Carcinoma Induced Renal Toxicity in Mice

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