RESPECT: Response Evaluation of Cancer Therapeutics in Metastatic Breast Cancer to the Bone – a Whole Body MRI Study

Abstract

mostly extrapolated for older populations, who are more likely to have comorbidities/impaired performance status, and not represent the clinical trial population. We reviewed our local practice to see how much chemotherapy our older patients actually receive. Methods: A retrospective, single-centre audit of patients over 60 years, treated with adjuvant chemotherapy for breast cancer from 2010 to 2015. Data were collected from clinical and pharmacy records. Primary outcomes were the type of intended chemotherapy, the percentage delivered and the frequency of dose reductions. Results: 84 patients received adjuvant chemotherapy: 32 were aged 60e64 years, 33 were 65e69 years and 19 were over 70 years. The majority had T2 tumours (50%; 73%; 63%), were node positive (56%; 67%; 74%) and HER2 positive (69%, 73% and 53%), whereas hormone positivity declined with age (88%; 73%; 42%) (60e64 years; 65e69 years; >70 years, respectively). Patients aged 60e64 years were most likely to receive FEC/FEC-T and on average completed 95.8% of their planned chemotherapy, with 25.3% of cycles dose reduced and 9.1% stopping chemotherapy early. 26.3% of patients >70 years stopped chemotherapy early, with 35.1% of cycles delivered at a reduced dose. Conclusion: There were differences in the baseline characteristics of patients over 65 years who were offered adjuvant chemotherapy compared with younger patients: patients over 65 years were more likely to be ER-ve and/or HER2þve. Patients over 65 years were also more likely to have multiple dose reductions, discontinue chemotherapy early and were least likely to receive third generation chemotherapy, even for node-positive disease. Patients who do not complete their adjuvant chemotherapy may not derive the benefi ti n 10 year survival proposed by nhs.predict. This should be taken into consideration when counselling elderly patients for adjuvant chemotherapy.