This article is more than 5 years old. Information may no longer be current.
Younger women with breast cancer responded better to neoadjuvant chemotherapy
SAN ANTONIO — Neoadjuvant chemotherapy was linked to more frequent pathological complete responses in women aged 35 years or younger, according to findings presented here at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium.
Sibylle Loibl, MD, PhD, an associate professor at the University of Frankfurt in Germany, said the study included 8,949 patients from eight neoadjuvant trials. There were three age groups: younger than 36 years, 36 to 50 years and at least 51 years.
“We compared pathological complete response rates overall and by subgroup,” Loibl said. DFS, local recurrence-free survival and OS were other outcome measures.
“Among women [in the youngest group], about one-third have triple-negative disease and one-third have HR-positive/HER-2–positive disease,” she said. About half of the women in the older age groups had HR-positive/HER-2–positive disease.
The overall pathological response rates were 23.6% among women in the youngest age group, 17.5% in the middle group and 13.5% in the oldest age group (P<.0001). Further analysis indicated that the difference in response rates could be attributed to women with triple-negative and luminal-like tumors.
“Age was an independent predictive factor,” Loibl said.
Women in the youngest group experienced significantly lower DFS rates than women in the middle age group (≤35 vs. ≥36-50: HR=0.83; 95% CI, 0.7-0.98). Similarly, women in the youngest group experienced poorer local recurrence-free survival (≤35 vs. ≥36-50: HR=0.74; 95% CI, 0.58-0.95).
Women in the youngest cohort with a luminal-like tumor who did not achieve a pathological complete response had worse DFS and local recurrence survival than those in the same age group with a pathological complete response.
“Very young women are more likely to achieve a pathological complete response after neoadjuvant chemotherapy,” Loibl said. “In contrast to other analyses, very young women with luminal-like tumors benefit from a pathological complete response.”
She said breast cancer in very young women is biologically different, and young women with luminal-like tumors should be considered for neoadjuvant chemotherapy.
For more information:
Loibl S. #S3-1. Presented at: the 2012 CTRC-AACR San Antonio Breast Cancer Symposium; Dec. 4-8, 2012; San Antonio.
Disclosure: Black reports no relevant financial disclosures.
Perspective
Back to Top
In general, with younger women, we tend to be more aggressive with chemotherapy. The importance of this study is that it suggests that there are some biological differences that may go beyond luminal B that we have to study. But, in general, we have a tendency to err on the side of an aggressive regimen with younger women.