Geburtshilfe Frauenheilkd 2018; 78(10): 280
DOI: 10.1055/s-0038-1671612
Freie Vorträge
Donnerstag, 01.11.2018
AGO Mamma State of the Art 2018: primäres Mammakarzinom
Georg Thieme Verlag KG Stuttgart · New York

Outcome after neoadjuvant chemotherapy in elderly breast cancer patients – a pooled analysis of individual patient data from eight prospectively randomized controlled trials

G von Waldenfels
1  Charité – Universitätsmedizin Berlin, Campus Mitte, Abteilung für Gynäkologie mit Brustzentrum, Berlin, Deutschland
,
S Loibl
2  German Breast Group GmbH, Neu-Isenburg, Deutschland
,
J Furlanetto
2  German Breast Group GmbH, Neu-Isenburg, Deutschland
,
A Machleidt
1  Charité – Universitätsmedizin Berlin, Campus Mitte, Abteilung für Gynäkologie mit Brustzentrum, Berlin, Deutschland
,
B Lederer
2  German Breast Group GmbH, Neu-Isenburg, Deutschland
,
C Denkert
3  Charité – Universitätsmedizin Berlin, Campus Mitte, Institut für Pathologie, Berlin, Deutschland
,
C Hanusch
4  Rotkreuzklinikum München, München, Deutschland
,
S Kümmel
5  Kliniken Essen Mitte, Essen, Deutschland
,
G von Minckwitz
2  German Breast Group GmbH, Neu-Isenburg, Deutschland
,
A Schneeweiss
6  Nationales Centrum für Tumorerkrankungen Heidelberg, Heidelberg, Deutschland
,
M Untch
7  HELIOS Klinikum Berlin-Buch, Berlin, Deutschland
,
K Rhiem
8  Zentrum familiärer Brust- und Eierstockkrebs, Universitätsklinik Köln, Köln, Deutschland
,
PA Fasching
9  Universitätsklinikum Erlangen, Erlangen, Deutschland
,
JU Blohmer
1  Charité – Universitätsmedizin Berlin, Campus Mitte, Abteilung für Gynäkologie mit Brustzentrum, Berlin, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
20 September 2018 (online)

 

Introduction:

Recent studies showed the high and independent impact of age on pathologic complete response (pCR) and prognosis for patients undergoing neoadjuvant chemotherapy (NACT). Some physicians might not consider elderly patients (> 65 years) for NACT due to poor prognosis or higher toxicity. The aim of this analysis is to help selecting appropriately elderly women who would benefit from NACT. Secondly, survival parameters are investigated in several histological subgroups.

Methods:

From 1998 to 2010, eight prospectively randomized German Breast Group (GBG) trials of anthracycline- and taxane-based NACT with 8949 patients were performed and analyzed in this study.

Results:

Compared to the overall average, elderly women had significant larger tumors and more overall lymph node involvement. Histologically, they had more G2 tumors, more estrogen-receptor positive tumors. pCR (ypT0 ypN0) was strongly associated with age. The multivariable logistic regression analysis of clinical parameters showed that young age, clinical stage T4, invasive ductal cancer and poor differentiated breast cancer are predictive for high pCR. The multivariate analyses of molecular subgroups showed that age > 65years is a predictor of significant lower pCR in HER2– breast cancers. Nonetheless, HER2+ patients showed pCR rates as high– and HR+/HER2+ higher – pCR rates compared to younger patients.

Discussion:

This study underlines the unfavorable impact of higher age on pCR, but it shows a realistic chance for pCR if NACT is applied – especially for HER2+ patients. Furthermore, elderly patients with non-TNBC showed a good prognosis (comparable to younger patients) regarding overall survival, even if they do not have pCR.