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'Soft' chemotherapy effective in the care of older breast cancer patients

Multicentre study finds targeted treatment with ‘soft’ chemotherapy could increase survival rates in older people with breast cancer
Chemotherapy

Targeted treatment with soft chemotherapy may be effective in the care of older people with secondary breast cancer and could increase survival rates.

The study, published in the Lancet Oncology, showed the results of a trial involving patients with histologically proven, HER2-positive metastatic breast cancer from eight European countries.

The 80 patients had no previous chemotherapy for metastatic disease, were over 60 years old and had a life expectancy of more than 12 weeks.

The authors of the study state that despite the high incidence of metastatic breast cancer and its related mortality in older people, knowledge about optimal treatment for older patients is far from adequate.

The researchers from Belgium found that the addition of metronomic oral cyclophosphamide to trastuzumab plus pertuzumab in older and frail patients increased median progression-free survival by seven months compared with dual HER2 blockade alone.

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Targeted treatment with ‘soft’ chemotherapy may be effective in the care of older people with secondary breast cancer and could increase survival rates.

The study, published in the Lancet Oncology, showed the results of a trial involving patients with histologically proven, HER2-positive metastatic breast cancer from eight European countries.

The 80 patients had no previous chemotherapy for metastatic disease, were over 60 years old and had a life expectancy of more than 12 weeks.

The authors of the study state that despite the high incidence of metastatic breast cancer and its related mortality in older people, knowledge about optimal treatment for older patients is ‘far from adequate’.

The researchers from Belgium found that the addition of metronomic oral cyclophosphamide to trastuzumab plus pertuzumab in older and frail patients increased median progression-free survival by seven months compared with dual HER2 blockade alone.

They added that trastuzumab and pertuzumab plus metronomic oral cyclophosphamide followed by trastuzumab emtansine after disease progression might delay or supersede the need for taxane chemotherapy in older patients.

Breast Cancer Care clinical nurse specialist for secondary breast cancer Catherine Priestley said: ‘These extremely encouraging findings could offer women over 60 with incurable breast cancer a very effective treatment without trading in their quality of life.

‘For those who cannot manage harder hitting treatments, adding a less toxic chemotherapy to a combination of drugs still puts the brakes on the cancer and avoids side effects that can make it impossible to get on with daily life.'


Find out more

Wildiers H, Tryfonidis K, Dal Lago L et al (2018) Pertuzumab and trastuzumab with or without metronomic chemotherapy for older patients with HER2-positive metastatic breast cancer (EORTC 75111-10114): an open-label, randomised, phase 2 trial from the Elderly Task Force/Breast Cancer Group. The Lancet Oncology 

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