The impact of adjuvant chemotherapy in older breast cancer patients on clinical and biological aging parameters

Brouwers, Barbara; Hatse, Sigrid; Lago, Lissandra Dal; Neven, Patrick; Vuylsteke, Peter; Dalmasso, Bruna; Debrock, Guy; Bulck, Hilde Van den; Smeets, Ann; Bechter, Oliver; Bailur, Jithendra Kini; Kenis, Cindy; Laenen, Annouschka; Schöffski, Patrick; Pawelec, Graham; Journé, Fabrice; Ghanem, Ghanem-Elias; Wildiers, Hans

doi:10.18632/oncotarget.8796

Cited by 44 publications

(31 citation statements)

References 55 publications

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“…Our findings of a general lack of difference in cytokines levels 1-2 years after surgery are in accord with those of Brouwers et al[62]. Similarly to us, they did not find differences in IL-6, IGF-1, and TNF-alpha.…”

Section: Discussionsupporting

confidence: 93%

“…It combines physical performance tests, biological testing, and activity measurement by both recording and questionnaires, allowing a detailed picture of the functioning of these patients. Another recent study combined functional (and CGA) questionnaires with a cytokines and telomere length evaluation but did not assess physical function[62]. …”

Section: Discussionmentioning

confidence: 99%

“…Therefore studies testing objective physical function in the adjuvant treatment setting appear to show overall a good tolerance on that aspect to chemotherapy. In their recent study, Brouwers et al did notice a decrease in global QOL measured by EORTC QLQ-30 and IADL (but not ADL) 3 months after surgery in the chemotherapy group but these all corrected to baseline 1 year after surgery[62]. …”

Section: Discussionmentioning

confidence: 99%

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Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Extermann

Leeuwenburgh

Samiian

et al. 2017

Journal of Geriatric Oncology

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Background Chemotherapy is less often prescribed in older individuals due to concerns about post-treatment morbidity and quality of life. We evaluated the physical performance of breast cancer survivors treated with and without adjuvant chemotherapy. Methods We conducted a case-control study in 56 estrogen receptor positive breast cancer survivors (BCS) on adjuvant aromatase inhibitors 1-2 years after definitive surgery. Cases had received adjuvant chemotherapy (n = 27; age 70.5±3.6 yrs) versus age-matched controls who had not (n = 29; age 70.0±4.3 yrs). Measures of grip strength, physical activity and performance, walking speed, fatigue, and self-reported physical function were collected. Biological correlates of inflammation, frailty and markers of DNA and RNA oxidation were compared. Results Grip strength (Controls: 21±7.4 vs. Cases: 29.7±5.0 kg, p=0.20), physical activity (5403±3204 vs. 6801±9320 steps/day, p=0.45), physical performance (Short Physical Performance Battery score: 10.1±1.8 vs. 10.4±1.1, p=0.52), long-distance walking speed (1.2±0.21 vs. 1.3±0.41 m/sec, p=0.17) were similar between the two groups. Self-reported physical function was marginally lower in cases than controls (Controls: 72±24 vs. Cases: 57±34 AU, p=0.07). Fatigue disruptiveness was not different between groups (Controls: 11.1±13.0 vs. Cases: 15.7±16.2 AUs, p=0.24). Similarly, the inflammation, oxidation, and frailty markers did not present a significant difference between groups, except for vitamin D levels (p=0.04). Conclusion Older women who received chemotherapy reported having slightly lower physical function, but a similar physical performance compared to women who did not. These data suggest that older BCS treated with chemotherapy recover to an extent similar to survivors who only received hormonal therapy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Extermann

Leeuwenburgh

Samiian

et al. 2017

Journal of Geriatric Oncology

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“…This is similar to previous reports in similar patient populations (i.e. breast cancer patients who underwent breast surgery) [30][31][32][33][34][35]. The median IL-6 and CRP peak concentrations (10.4 pg ml -1 and 15.5 mg l -1 , respectively) were typically observed around 8 and 8.5 days after dose, respectively, among patients who were estimated to have a peak in the current study.…”

Section: Discussionsupporting

confidence: 91%

The risk of febrile neutropenia in breast cancer patients following adjuvant chemotherapy is predicted by the time course of interleukin‐6 and C‐reactive protein by modelling

Netterberg

Karlsson

Nielsen

et al. 2018

Brit J Clinical Pharma

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“… 12 , 27 Additional markers of the biological aging process that may be relevant in the context of cancer treatments include telomere length, a repeat sequence of DNA at the end or chromosomes, which shortens with cellular replication and can initiate senescence, and telomerase activity, an enzyme that rebuilds telomeres, 28 but whose function is no longer necessary in senescent cells. While some evidence suggests cancer treatments do not impact leukocyte telomere length, 23 , 29 others have reported shorter telomere length among cancer survivors. 30 – 32 Thus, whether cancer treatment impacts telomere length is inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of aging associated with past treatments in breast cancer survivors

et al. 2017

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Radiation and chemotherapy are effective treatments for cancer, but are also toxic to healthy cells. Little is known about whether prior exposure to these treatments is related to markers of cellular aging years later in breast cancer survivors. We examined whether past exposure to chemotherapy and/or radiation treatment was associated with DNA damage, telomerase activity, and telomere length 3–6 years after completion of primary treatments in breast cancer survivors (stage 0–IIIA breast cancer at diagnosis). We also examined the relationship of these cellular aging markers with plasma levels of Interleukin (IL)-6, soluble TNF-receptor-II (sTNF-RII), and C-reactive protein (CRP). Ninety-four women (36.4–69.5 years; 80% white) were evaluated. Analyses adjusting for age, race, BMI, and years from last treatment found that women who had prior exposure to chemotherapy and/or radiation compared to women who had previously received surgery alone were more likely to have higher levels of DNA damage (P = .02) and lower telomerase activity (P = .02), but did not have differences in telomere length. More DNA damage and lower telomerase were each associated with higher levels of sTNF-RII (P’s < .05). We found that exposure to chemotherapy and/or radiation 3–6 years prior was associated with markers of cellular aging, including higher DNA damage and lower telomerase activity, in post-treatment breast cancer survivors. Furthermore, these measures were associated with elevated inflammatory activation, as indexed by sTNF-RII. Given that these differences were observed many years after the treatment, the findings suggest a long lasting effect of chemotherapy and/or radiation exposure.

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The impact of adjuvant chemotherapy in older breast cancer patients on clinical and biological aging parameters

Cited by 44 publications

References 55 publications

Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

The risk of febrile neutropenia in breast cancer patients following adjuvant chemotherapy is predicted by the time course of interleukin‐6 and C‐reactive protein by modelling

Biomarkers of aging associated with past treatments in breast cancer survivors

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