Impact of chemotherapy relative dose intensity on cause-specific and overall survival for stage I–III breast cancer: ER+/PR+, HER2− vs. triple-negative

Details

• Alternative Title:
  Breast Cancer Res Treat
• Personal Author:
  Zhang, Lu ; Yu, Qingzhao ; Wu, Xiao-Cheng ; Hsieh, Mei-Chin ; Loch, Michelle ; Chen, Vivien W. ; Fontham, Elizabeth ; Ferguson, Tekeda
• Description:
  Purpose
  
  To investigate the impact of chemotherapy relative dose intensity (RDI) on cause-specific and overall survival for stage I–III breast cancer: estrogen receptor or progesterone receptor positive, human epidermal-growth factor receptor negative (ER+/PR+ and HER2−) vs. triple-negative (TNBC) and to identify the optimal RDI cut-off points in these two patient populations.
  
  Methods
  
  Data were collected by the Louisiana Tumor Registry for two CDC-funded projects. Women diagnosed with stage I–III ER+/PR+, HER2− breast cancer, or TNBC in 2011 with complete information on RDI were included. Five RDI cut-off points (95, 90, 85, 80, and 75%) were evaluated on cause-specific and overall survival, adjusting for multiple demographic variables, tumor characteristics, comorbidity, use of granulocyte-growth factor/cytokines, chemotherapy delay, chemotherapy regimens, and use of hormone therapy. Cox proportional hazards models and Kaplan–Meier survival curves were estimated and adjusted by stabilized inverse probability treatment weighting (IPTW) of propensity score.
  
  Results
  
  Of 494 ER+/PR+, HER2− patients and 180 TNBC patients, RDI < 85% accounted for 30.4 and 27.8%, respectively. Among ER+/PR+, HER2− patients, 85% was the only cut-off point at which the low RDI was significantly associated with worse overall survival (HR = 1.93; 95% CI 1.09–3.40). Among TNBC patients, 75% was the cut-off point at which the high RDI was associated with better cause-specific (HR = 2.64; 95% CI 1.09, 6.38) and overall survival (HR = 2.39; 95% CI 1.04–5.51).
  
  Conclusions
  
  Higher RDI of chemotherapy is associated with better survival for ER+/PR+, HER2− patients and TNBC patients. To optimize survival benefits, RDI should be maintained ≥ 85% in ER+/PR+, HER2− patients, and ≥ 75% in TNBC patients.
  
  
• Subjects:
  Adult Aged Article Breast Cancer Breast Neoplasms Chemotherapy Disease-Free Survival Dose-Response Relationship, Drug Female Hormone Receptor Positive Humans Kaplan-Meier Estimate Middle Aged Neoplasm Staging Receptor, ErbB-2 Receptors, Estrogen Receptors, Progesterone Relative Dose Intensity Triple-negative Triple Negative Breast Neoplasms

  More +
• Source:
  Breast Cancer Res Treat. 169(1):175-187
• Pubmed ID:
  29368311
• Pubmed Central ID:
  PMC6190707
• Document Type:
  Journal Article
• Funding:
  R15 MD012387/MD/NIMHD NIH HHS/United States ; U58 DP003915/DP/NCCDPHP CDC HHS/United States ; 1eEDSK0106/Centers for Disease Control and Prevention/ ; 5NU58DP003915/Centers for Disease Control and Prevention/
• Volume:
  169
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2a1c59659573b972aafaf362805a8e94f29ca88b964fb08fc1532f2dd2a2a8b1
• Download URL:
  https://stacks.cdc.gov/view/cdc/59825/cdc_59825_DS1.pdf
• File Type:
  [PDF - 1.52 MB ]