Treatment of breast cancer in older women

Figures & data

Table I.  Randomized trials of surgical treatment for breast cancer in older women.

Trial	Follow-up	Surgery arm	Tamoxifen arm
St George's Hospital	6 years	n = 100	n = 100
Local relapse/progression		44%	56%
Breast cancer deaths		15%	17%
Other deaths		13%	16%
Nottingham City Hospital	12 years	n = 65	n = 66
Local relapse/progression		38%	81%
Breast cancer deaths		22	20
Other deaths		24	25
CRC Elderly Trial	12.3 years	n = 225	n = 230
Local relapse/progression		21%	46%
Breast cancer deaths		19%	30%
Other deaths		51%	52%
GRETA	6.75 years	n = 239	n = 235
Local relapse/progression		11%	40%
Breast cancer deaths		23%	24%
Other deaths		21%	37%
EORTC 10851	10 years	82	82
Local relapse/progression		9%	57%
Breast cancer deaths		23%	28%
Other deaths		50%	33%

Table II.  First line endocrine therapy in older women with advanced breast cancer comparing fulvestrant and aromatase inhibitors with tamoxifen.

	Fulvestrant F vs T^(96)	Anastrozole A vs T^(90)	Letrozole L vs T^(91)	Exemestane E vs T^(92)
No of patients	313 vs 274	511 vs 510	453 vs 454	190 vs 192
Obj. Resp. %	31.6 vs 33.9	29.0 vs 27.1	32* vs 21	44.2 vs 29,2
Clin. Benefit %	54.3 vs 62.0*	57.1 vs 52.0	50* vs 38	71.6 vs 65.2
(ER/PgR pos.)	(57.1 vs 62.7)
Med PFS (mos)	6.8 vs 8.3	8.5 vs 7.0	9.4* vs 6.0	10.9* vs 6.7
(ER/PgR pos.)	(8.2 vs 8.3)	(10.7* vs 6.4)

*statistically significant.

Table III.  Activity of single drugs in older patients with metastatic breast cancer.

Study	Drug	No of Pts	Median Age	Pretreated (%)	CR + PR (%)	Neutropenia Grade 3–4 (%)
Hainsworth [101]	Docetaxel Weekly	41	74	25	36	2 (4.8)
Del Mastro [102]	Weekly Taxol	46	70	0	54	4 (8.8)
Feher [103]	Gemcitabine	198	69	0	16	47 (25.3)
	Epirubicin	199	68	0.5	40	34 (17.9)
Repetto [104]	Mitoxanttrone	27	77	0	26	2 (8)
Vogel [105]	Vinorelbine	56	72	0	38	14 (25)
Bajetta [106]	Capecitabine	73	73	10	27	1 (2%)
Crivellari [107]	Idarubicin	47	75	0	22	4 (12)

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