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 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 April 2012" - "CODEN: ANONE" - "Source: Scopus" |
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