Breast Cancer Research and Treatment

, Volume 146, Issue 1, pp 1–6 | Cite as

Breast cancer and aging: results of the U13 conference breast cancer panel

  • M. F. Barginear
  • H. Muss
  • G. Kimmick
  • C. Owusu
  • E. Mrozek
  • A. Shahrokni
  • K. Ballman
  • A. Hurria
Review

Abstract

Breast cancer is predominantly a disease of older women, yet there is a knowledge gap due to the persisting misalignment between the age distribution of women with breast cancer and the age distribution of participants in clinical trials. The purpose of this report is to state the U13 conference breast cancer panel’s recommendations regarding therapeutic clinical trials that will fill gaps in knowledge regarding the care of older patients with breast cancer. The U13 conference was a collaboration between the Cancer and Aging Research Group and the National Institute on Aging and the National Cancer Institute (NCI). Clinical trials should be developed for frail and vulnerable patients who would not enroll on the standard phase III trials, as well as efforts need to be made to increase enrollment of fit older patients on standard phase III trials. As a result of this conference, panel members are working with the NCI and cooperative groups to address these knowledge gaps. With the aging population and increasing incidence of breast cancer with age, it is essential to study the feasibility, toxicity, and efficacy of cancer therapy in this at-risk population.

Keywords

Breast cancer Aging Elderly 

Notes

Acknowledgments

The study was supported by the U13 conference grant (U13 AG038151). The study sponsors were not involved in the writing of the article or the decision to submit it for publication. The authors were independent from study sponsors.

References

  1. 1.
    Desantis C, Siegel R, Bandi P et al (2011) Breast cancer statistics. CA Cancer J Clin 61:409–418PubMedCrossRefGoogle Scholar
  2. 2.
    Siegel R, DeSantis C, Virgo K et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–241PubMedCrossRefGoogle Scholar
  3. 3.
    Smith BD, Smith GL, Hurria A et al (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765PubMedCrossRefGoogle Scholar
  4. 4.
    McDermott AM, Toelle TR, Rowbotham DJ et al (2006) The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain 10:127–135PubMedCrossRefGoogle Scholar
  5. 5.
    McDonald M, Hertz RP, Unger AN et al (2009) Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci 64:256–263PubMedCrossRefGoogle Scholar
  6. 6.
    Owusu C, Hurria A, Muss H (2012) Adjuvant therapy for older women with early-stage breast cancer: treatment selection in a complex population. Am Soc Clin Oncol Educ Book 32:3–9Google Scholar
  7. 7.
    Minino AM, Murphy SL (2012) Death in the United States, 2010. NCHS Data Brief 1–8Google Scholar
  8. 8.
    Early Breast Cancer Trialists' Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717CrossRefGoogle Scholar
  9. 9.
    van de Water W, Markopoulos C, van de Velde CJ et al (2012) Association between age at diagnosis and disease-specific mortality among postmenopausal women with hormone receptor-positive breast cancer. JAMA 307:590–597Google Scholar
  10. 10.
    Lichtman SM, Wildiers H, Chatelut E et al (2007) International Society of Geriatric Oncology Chemotherapy Taskforce: evaluation of chemotherapy in older patients–an analysis of the medical literature. J Clin Oncol 25:1832–1843PubMedCrossRefGoogle Scholar
  11. 11.
    Kemeny MM, Peterson BL, Kornblith AB et al (2003) Barriers to clinical trial participation by older women with breast cancer. J Clin Oncol 21:2268–2275PubMedCrossRefGoogle Scholar
  12. 12.
    Kimmick GG, Muss HB (2001) Systemic therapy for older women with breast cancer. Oncology (Williston Park) 15:280–291; discussion 291–292, 295–296, 299Google Scholar
  13. 13.
    Muss HB, Woolf S, Berry D et al (2005) Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA 293:1073–1081PubMedCrossRefGoogle Scholar
  14. 14.
    Lichtman SM, Skirvin JA (2000) Pharmacology of antineoplastic agents in older cancer patients. Oncology (Williston Park) 14:1743–1755; discussion 1755, passimGoogle Scholar
  15. 15.
    Ramjaun A, Nassif MO, Krotneva S et al (2013) Improved targeting of cancer care for older patients: a systematic review of the utility of comprehensive geriatric assessment. J Geriatr Oncol 4:271–281PubMedCrossRefGoogle Scholar
  16. 16.
    Wildes TM, Ruwe AP, Fournier C et al (2013) Geriatric assessment is associated with completion of chemotherapy, toxicity, and survival in older adults with cancer. J Geriatr Oncol 4:227–234PubMedCrossRefGoogle Scholar
  17. 17.
    Citron ML, Berry DA, Cirrincione C et al (2003) Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 21:1431–1439PubMedCrossRefGoogle Scholar
  18. 18.
    Hurria A, Togawa K, Mohile SG et al (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29:3457–3465PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Pinder MC, Duan Z, Goodwin JS et al (2007) Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol 25:3808–3815PubMedCrossRefGoogle Scholar
  20. 20.
    Thomas ES, Gomez HL, Li RK et al (2007) Ixabepilone plus capecitabine for metastatic breast cancer progressing after anthracycline and taxane treatment. J Clin Oncol 25:5210–5217PubMedCrossRefGoogle Scholar
  21. 21.
    Baselga J, Campone M, Piccart M et al (2012) Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 366:520–529PubMedCrossRefGoogle Scholar
  22. 22.
    Bunnell C, Vahdat L, Schwartzberg L et al (2008) Phase I/II study of ixabepilone plus capecitabine in anthracycline-pretreated/resistant and taxane-resistant metastatic breast cancer. Clin Breast Cancer 8:234–241PubMedCrossRefGoogle Scholar
  23. 23.
    Cortes J, O’Shaughnessy J, Loesch D et al (2011) Eribulin monotherapy versus treatment of physician’s choice in patients with metastatic breast cancer (EMBRACE): a phase 3 open-label randomised study. Lancet 377:914–923PubMedCrossRefGoogle Scholar
  24. 24.
    Blackwell KL MD, Gianni L, et al (2012) Primary results from EMILIA, a phase 3 study of trastuzumab emtansine (T-DM1) vs capecitabine and lapatinib in HER2-positive locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane. 2012 ASCO Annual Meeting. Abstract LBA1. Presented June 3Google Scholar
  25. 25.
    Baselga J, Cortes J, Kim SB et al (2012) Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med 366:109–119PubMedCrossRefGoogle Scholar
  26. 26.
    Geyer CE, Forster J, Lindquist D et al (2006) Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 355:2733–2743PubMedCrossRefGoogle Scholar
  27. 27.
    Schwartzberg LS, Franco SX, Florance A et al (2010) Lapatinib plus letrozole as first-line therapy for HER-2 + hormone receptor-positive metastatic breast cancer. Oncologist 15:122–129PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • M. F. Barginear
    • 1
  • H. Muss
    • 1
    • 2
  • G. Kimmick
    • 1
    • 3
  • C. Owusu
    • 1
    • 4
  • E. Mrozek
    • 1
    • 5
  • A. Shahrokni
    • 1
    • 6
  • K. Ballman
    • 1
    • 7
  • A. Hurria
    • 1
    • 8
  1. 1.Hofstra-North Shore LIJ School of MedicineNorth Shore-LIJ Cancer InstituteLake SuccessUSA
  2. 2.UNC Lineberger Comprehensive Cancer CenterChapel HillUSA
  3. 3.Duke University Medical CenterDurhamUSA
  4. 4.Case Western Reserve University School of MedicineClevelandUSA
  5. 5.The Ohio State UniversityColumbusUSA
  6. 6.Memorial Sloan Kettering Cancer CenterNYUSA
  7. 7.Mayo ClinicRochesterUSA
  8. 8.City of Hope Comprehensive Cancer CenterDuarteUSA

Personalised recommendations