About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Elderly Cancer Patients may Live Longer With Soft Chemotherapy

by Chrisy Ngilneii on February 10, 2018 at 4:58 PM
Font : A-A+

Elderly Cancer Patients may Live Longer With Soft Chemotherapy

In older patients with an aggressive breast cancer subtype where the cancer has spread to other parts of the body, medically known as HER2 positive metastatic breast cancer, a combination of a soft chemotherapy with anti-HER2 therapy is highly active and has low toxicity, research at the European Organisation for Research and Treatment of Cancer claims.

Avoidance of side-effects of chemotherapy is particularly important in the elderly, but finding the balance between reduced toxicity and maximum effectiveness is not always easy.

Advertisement


Professor Hans Wildiers, a medical oncologist from the University Hospital Leuven, Belgium, and colleagues from Italy, the UK, Portugal, and France, randomized 80 patients to the targeted therapies trastumuzab and pertuzumab (TP) or to TP plus metronomic oral cyclophosphamide (TPM). The patients were aged 70 plus, or, if they were non-fit in other respects than their cancer, 60 plus. The median [4] age of participants was 76.7 years.

We know that the chemotherapy agent docetaxel combined with TP is effective in younger patients with HER2 positive metastatic breast cancer, but docetaxel is classical chemotherapy that can be significantly toxic and thus affect quality of life (QoL) especially in older women. Of course, QoL is important for all patients, but it has special significance in the elderly, particularly when used for palliation," Prof Wilders says.
Advertisement

"We therefore decided to study whether combining TP with the softer chemotherapy metronomic oral cyclophosphamide, would be active and have less toxicity than when used with docetaxel, or whether we could even omit chemotherapy and only administer TP in this age group. If tumor progression occurred after TPM or TP, patients would be eligible to receive another targeted drug, T-DM1, which is also generally well tolerated."

The researchers found that the TPM regime gave seven months longer progression-free survival, the length of time during which a patient lives with the disease without it getting worse - compared with TP alone (median progression-free survival 13 months versus six months). T-DM1 was also active, with a median disease control period of six months, after TPM or TP. Toxicity for all regimens was very acceptable in this frail population, they say. Nine out of the 29 deaths during the study period were not breast cancer-related.

These results were encouraging, says Prof Wildiers, since we found that, with gentle therapy, we could delay tumor growth in a significant proportion of frail patients for long periods. Our study also indicates that TPM and T-DM1 allow us to delay, or even avoid entirely, more toxic chemotherapy like docetaxel in these patients. In this age group, maintenance of QoL and the avoidance of toxic side-effects may be just as important as survival.

We believe that there is a strong case for carrying out trials designed specifically for older people. However, financial support for such trials is very difficult to find. Additionally, older patients are far less likely to receive standard chemotherapy, and are also unlikely to be included in a randomized trial where there is a risk that they will receive a treatment with high toxicity."

Pharmaceutical companies are reluctant to support trials involving the elderly for a number of reasons, the researchers say. There is little direct benefit for companies, and unexpected toxicity may present new molecules in a bad light. Additionally, it is important to include frailty measurement in future trials; most trials include some elderly but only those who are fit. New drugs should also be evaluated in frail older persons, who represent a large proportion of the real-life population, they say.

Dr Denis Lacombe, EORTC Director General, said: "These impressive results underline how important it is to investigate drug efficacy and tolerance in older patients. Older people, particularly those who are frail, are a special case in exactly the same way as children are. We cannot and must not assume that because a drug is effective and relatively free of side effects in young to middle-aged adults that it will be the same for the elderly.

"Given that cancer tends to be a disease of old age, it is irresponsible to overlook special needs in this field. We hope that regulators will listen to our views and put in place measures designed to encourage industry to carry out trials that include the older and frail patients who make up a large proportion of those affected by cancer. Only this way will they get medicines that are not just effective against tumors, but that also meet the requirement of providing a good quality of life."

The complete research is published in the journal The Lancet Oncology.

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Advertisement
News Category
What's New on Medindia
International Day of Persons with Disabilities 2021 - Fighting for Rights in the Post-COVID Era
Effect of Blood Group Type on COVID-19 Risk and Severity
Woman with Rare Spinal Cord Defect from Birth Sues Doctor
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Cancer and Homeopathy Chronic Lymphocytic Leukemia Hodgkins Lymphoma Non-Hodgkins Lymphoma Chemotherapy Chemotherapy Drugs Cancer Facts Tips to Live Longer Cancer Tattoos A Body Art 

Recommended Reading
Breast Cancer
Breast cancer is a cancer that affects the breasts or mammary glands. Early detection and lifestyle ...
Breast Lumps in Women - Symptom Evaluation
Most breast lumps are caused by hormonal changes in a woman and may not be cancerous. Keeping the .....
Breast Cancer Screening using Mammogram
Breast cancer if detected early can be completely cured. Mammography is used to screen women for ......
Inherited Breast Cancer Syndromes
Inherited breast cancers are caused due to mutations in genes that increase the risk of breast ......
Chemotherapy
‘Chemo’ means medicine or ‘drug’; ‘therapy’ means ‘treatment’. Chemotherapy refers to the use of cy...
Chemotherapy Drugs
Chemotherapy drugs perform like ‘magic bullets’ to destroy cancer cells in the body....
Chronic Lymphocytic Leukemia
Chronic Lymphocytic Leukemia (CLL) is one of the most common types of adult leukemia and is consider...
Hodgkins Lymphoma
Hodgkins lymphoma or Hodgkins disease has the distinction of being the first cancer to be cured by c...
Non-Hodgkins Lymphoma
Non Hodgkins Lymphoma is a cancer that affects the lymph tissues. It is made up of a wide array of ....
Tattoos A Body Art
Tattoos are a rage among college students who sport it for the ‘cool dude’ or ‘cool babe’ look...
Tips to Live Longer
Though life is temporary and short, it is possible to maximize the span of our existence by living h...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use