Feasibility and safety of weekly sequential epirubicin-paclitaxel as adjuvant treatment for operable breast cancer patients older than 70 years.
ABSTRACT There are currently no internationally agreed recommendations for the management of adjuvant chemotherapy in women aged >70 years with high-risk breast cancer. The purpose of this study was to assess the feasibility and the tolerance of adjuvant weekly sequential epirubicin-paclitaxel combination in this setting.
From 2005 to 2009, 59 women over 70 years of age with operable breast cancer and who required adjuvant chemotherapy were proposed weekly sequential epirubicin-paclitaxel chemotherapy schedule, and were prospectively registered. Compliance and treatment tolerance were studied. We also report preliminary results of disease-free survival (DFS) and overall survival (OS).
Weekly sequential epirubicin-paclitaxel was well tolerated. No grade 4 adverse event occurred. No secondary malignancy was observed. Compliance with chemotherapy was good: 95% of patients received the six planned cycles. After a median follow-up of 24 months, median DFS and OS were not reached, there were only three relapses, and two cancer-related deaths were reported.
This study conducted in patients over 70 years of age demonstrates the feasibility of weekly adjuvant chemotherapy including anthracyclines and taxanes in a sequential schedule. This regimen is safe in terms of hematologic, nonhematologic, and cardiac toxicities, and showed encouraging efficacy, justifying further studies in geriatric patients.