TY - JOUR
T1 - The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (Alliance)
AU - Gajra, Ajeet
AU - McCall, Linda
AU - Muss, Hyman B.
AU - Cohen, Harvey J.
AU - Jatoi, Aminah
AU - Ballman, Karla V.
AU - Partridge, Ann H.
AU - Sutton, Linda
AU - Parker, Barbara A.
AU - Magrinat, Gustav
AU - Klepin, Heidi D.
AU - Lafky, Jacqueline M.
AU - Hurria, Arti
N1 - Funding Information:
Support: Research reported in this publication was supported by grants National Cancer Institute of the National Institutes of Health under Award Number U10CA189823 (Alliance for Clinical Trials in Oncology NCORP Research Grant), U10CA180821 and U10CA180882 (to the Alliance for Clinical Trials in Oncology), U10CA003927 , U10CA007968 , U10CA011789 , U10CA180790 , U10CA180838 , U10CA180857 , UG1CA189858 and U10CA180867 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Dr. Gajra serves as a consultant for Bayer and BMS. Dr. Hurria has received research funding from Celgene, Novartis, and GSK as well as served as a consultant for Boehringer Ingelheim Pharmaceuticals, Carevive, Sanofi, GTx, Inc., Pierian Biosciences, and MJH Healthcare Holdings, LLC outside the submitted work. The authors have no other disclosures to report.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/5
Y1 - 2018/5
N2 - Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47% had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95% vs. 78%, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53% vs. 34%, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.
AB - Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47% had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95% vs. 78%, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53% vs. 34%, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.
KW - Adjuvant chemotherapy
KW - Breast cancer
KW - Decision-making
KW - Elderly
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U2 - 10.1016/j.jgo.2018.02.003
DO - 10.1016/j.jgo.2018.02.003
M3 - Article
C2 - 29602735
AN - SCOPUS:85044527555
SN - 1879-4068
VL - 9
SP - 221
EP - 227
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 3
ER -