Paclitaxel efficacy and toxicity in older women with metastatic breast cancer: Combined analysis of calgb 9342 and 9840 Journal Article

Authors: Lichtman, S. M.; Hurria, A.; Cirrincione, C. T.; Seidman, A. D.; Winer, E.; Hudis, C.; Cohen, H. J.; Muss, H. B.
Article Title: Paclitaxel efficacy and toxicity in older women with metastatic breast cancer: Combined analysis of calgb 9342 and 9840
Abstract: Background: Two Cancer and Leukemia Group B (CALGB) studies were utilized to determine the efficacy and tolerability of paclitaxel (Taxol) in older patients with metastatic breast cancer. Patients and methods: CALGB 9840 evaluated weekly paclitaxel (80 mg/m. 2) versus paclitaxel every 3 weeks (175 mg/m. 2); CALGB 9342 evaluated three doses of paclitaxel as follows: 175, 210 and 250 mg/m. 2 each over 3 h every 3 weeks. Of the 1048 patients, paclitaxel was used first line in 57%. The groups: (i) <55 years (45%), (ii) 55-64 years (29%), and (iii) ≥65 years (26%). Results: Tumor response was also similar among age groups. First-line therapy (P = 0.0001) and better performance status (PS) (P = 0.018) were significantly related to higher response. Age did not significantly relate to overall survival (OS) or progression-free survival (PFS). First-line therapy, better PS, estrogen receptor positive status and a fewer number of metastatic sites were significantly related to improved OS and PFS. The grade ≥3 toxic effects that increased linearly with age were leucopenia (P = 0.0099), granulocytopenia (P = 0.022), anorexia (P = 0.028), bilirubin elevation (P = 0.0035) and neurotoxicity (P < 0.0001). Patients over 65 years receiving second-line therapy had the shortest time to neurotoxicity. Conclusions: Older women with breast cancer derive similar efficacy from treatment with paclitaxel as younger women. Older women are at increased risk for specific toxic effects. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Keywords: paclitaxel; neurotoxicity; breast cancer; elderly; geriatrics; geriatric oncology
Journal Title: Annals of Oncology
Volume: 23
Issue: 3
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2012-03-01
Start Page: 632
End Page: 638
Language: English
DOI: 10.1093/annonc/mdr297
PROVIDER: scopus
PUBMED: 21693770
PMCID: PMC3331731
Notes: --- - "Export Date: 2 April 2012" - "CODEN: ANONE" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Andrew D Seidman
    290 Seidman
  2. Clifford Hudis
    900 Hudis
  3. Stuart Lichtman
    202 Lichtman