Chemotherapy of Metastatic Breast Cancer in the Elderly: The Piedmont Oncology Association Experience

Abstract

Objective. —To determine the effect of age on treatment outcome in women with metastatic breast cancer treated with chemotherapy. Design. —Case-comparison study of patients with metastatic breast cancer treated in five clinical trials of the Piedmont Oncology Association. Setting. —University and private practice physicians participating in the Piedmont Oncology Association clinical trials in the southeastern United States. Patients. —Seventy patients 70 years of age or older were compared with 60 patients aged 50 through 69 years and 40 patients less than 50 years of age. All patients were ambulatory or capable of self-care, with adequate hematologic, renal, and hepatic function. Interventions. —Treatment with multidrug chemotherapy regimens. Main Outcome Measures. —Response to treatment, time to disease progression, survival, and toxic effects. Results. —Pretreatment characteristics including race, performance status, disease-free interval, prior therapy, sites of metastatic disease, and number and dominant sites of metastases were similar for the three age groups. The response rates for the younger-than-50, 50-through-69, and 70-or-older age groups were 40%, 31%, and 29%, respectively (P=.53). There were no significant differences in time to disease progression or survival for patients in the three age groups. Estimates for time to progression and survival were 9.1 and 17.9 months, 6.2 and 12.8 months, and 7.2 and 14.2 months, respectively. Toxic effects, dose delivery, and dose delays were also similar for all three age groups. Conclusions. —Women 70 years of age or older who were enrolled in these trials were similar to their younger counterparts in response rates, time to disease progression, survival, and toxic effects. Women in this age group should not be excluded, based on age alone, from clinical trials involving chemotherapy for advanced breast cancer. (JAMA. 1992;268:57-62)