Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are NOT suitable for a "standard chemotherapy regimen": The CASA randomized trial

被引:41
作者
Crivellari, Diana [1 ]
Gray, Kathryn P. [2 ,3 ]
Dellapasqua, Silvia [4 ]
Puglisi, Fabio [5 ]
Ribi, Karin [6 ]
Price, Karen N. [7 ,8 ]
Lang, Istvan [9 ]
Gianni, Lorenzo [10 ,11 ]
Spazzapan, Simon [1 ]
Pinotti, Graziella [12 ,13 ]
Luethi, Jean-Marc [14 ]
Gelber, Richard D. [2 ,3 ,15 ]
Regan, Meredith M. [2 ,15 ]
Colleoni, Marco [4 ]
Castiglione-Gertsch, Monica [16 ]
Maibach, Rudolf [8 ,17 ]
Rabaglio, Manuela [17 ,18 ]
Coates, Alan S. [19 ,20 ]
Goldhirsch, Aron [21 ]
机构
[1] Ctr Riferimento Oncol, I-33081 Aviano, Italy
[2] Dana Farber Canc Inst, Dept Biostat & Computat Biol, IBCSG, Ctr Stat, Boston, MA 02115 USA
[3] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA
[4] European Inst Oncol, Dept Med, Res Unit Med Senol, Milan, Italy
[5] Univ Udine, Dept Med & Biol Sci, I-33100 Udine, Italy
[6] Int Breast Canc Study Grp, Coordinating Ctr, Qual Life Off, Bern, Switzerland
[7] Int Breast Canc Study Grp, Ctr Stat, Boston, MA USA
[8] Frontier Sci & Technol Res Fdn Inc, Boston, MA USA
[9] Natl Inst Oncol, Budapest, Hungary
[10] Osped Infermi Rimini, Dept Oncol, Rimini, Italy
[11] Ist Sci Romagnolo Studio & Cura Tumori, Rimini, Italy
[12] Osped Circolo Varese, Varese, Italy
[13] Fdn Macchi, Varese, Italy
[14] Spital SIS AG, Thun, Switzerland
[15] Harvard Univ, Sch Med, Boston, MA USA
[16] Univ Geneva, Dept Med Hop, Unite Oncogynecol Med, Geneva, Switzerland
[17] Int Breast Canc Study Grp, Coordinating Ctr, Bern, Switzerland
[18] Univ Bern, Inselspital, Dept Med Oncol, CH-3010 Bern, Switzerland
[19] Int Breast Canc Study Grp, Sydney, NSW, Australia
[20] Univ Sydney, Sydney, NSW 2006, Australia
[21] European Inst Oncol, Dept Med, Milan, Italy
关键词
Adjuvant treatment; Endocrine nonresponsive; Chemotherapy; Pegylated liposomal doxorubicin; Elderly; Breast cancer; QUALITY-OF-LIFE; ELDERLY-PATIENTS PTS; INTERNATIONAL SOCIETY; CAPECITABINE X; IBANDRONATE I; MINI-COG; PHARMACOKINETICS; CYCLOPHOSPHAMIDE; RECOMMENDATIONS; METHOTREXATE;
D O I
10.1016/j.breast.2013.01.015
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
There is no optimal treatment for breast cancers lacking estrogen (ER) and progesterone (PgR) receptors in elderly women with co-morbidities that prevent use of "standard chemotherapy regimens" such as AC or CMF. The CASA trial studied pegylated liposomal doxorubicin (PLD) and low dose, metronomic cyclophosphamide methotrexate (CM) for older (>65), vulnerable women with operable, ER and PgR-negative breast cancer. After two years the trial closed early, due to slow and inadequate accrual, with 77 patients (38:PLD, 36:CM, 3:nil). Sixty-eight percent completed PLD; 83% completed CM (both 16 weeks). Patients on PLD reported worse quality of life, cognitive and physical functioning than non-PLD regimens (primarily CM). At a median follow-up of 42 months, 81% of randomized patients remained free of any breast cancer recurrence. Based on our limited experience, PLD and CM may be reasonable options for further study for elderly vulnerable patients with endocrine nonresponsive breast cancer. (C) 2013 Elsevier Ltd. All rights reserved.
引用
收藏
页码:130 / 137
页数:8
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