Furthermore,
No significant benefit chemotherapy hormonosensible:
The French study ASTER 70S shows that the addition of chemotherapy to hormone therapy does not provide a significant survival benefit in women aged 70. Therefore, more affected by Hormonosensible breast cancer. For example, The results of this study are published in The Lancet.
“The question of the interest of adjuvant chemotherapy in elderly women with hormonosensible breast cancer is controversial. Similarly, ASTER 70S is the first randomized phase 3 study to assess the benefit of adjuvant chemotherapy in this high -risk population. Nevertheless, Comments Professor Etienne Brain, medical oncologist at the Institut Curie and principal investigator, in a press release from Unicancer and the Institut Curie. Similarly, It is a turning point in the management of elderly women with breast cancer. Furthermore, »»
The ASTER 70S study was designed. Consequently, coordinated by Unicancer R&D in partnership with the no significant benefit chemotherapy hormonosensible teams of the Institut Curie. For example, She mobilized the Gerico. UCBG research groups specializing in oncogeriatrics and breast cancer, and relied on 84 public and private investigating centers in France and Belgium.
With chemotherapy. 1/3 of patients with side effects of grade 3 – No significant benefit chemotherapy hormonosensible
The study included 1,089 patients aged 70 and over with breast cancer ER +/HER2- at high genomic risk (tested with the genomic grade index) randomized to receive, either chemotherapy (three diet options) followed by hormone therapy (n = 541), or hormone therapy alone (n = 548). Patients had never received a systemic treatment and had previously undergone surgery; Among the participants, 40 % were considered fragile (G8 score). At four years old, the survival rate was 90.5 % in the chemotherapy group against 89.3 % in the group without chemotherapy. At eight years old, rates were 72.7 and 68.3 %respectively, “A difference from 4.5 no significant benefit chemotherapy hormonosensible points to eight years not statistically significant”, comment on the authors. Thus, after a 7.8 -year -old median follow -up. the results show that adding chemotherapy does not provide significant benefit in terms of global survival.
In addition. adjuvant chemotherapy has proven to be significantly more toxic than hormone therapy alone with 34 % adverse effects of serious 3 in the chemotherapy + hormone therapy (against 9 %). Patients who have received chemotherapy ” reported a more marked deterioration of their quality of life. especially in connection with fatigue, pain, digestive disorders and a drop in autonomy ”.
Seniors. excluded from major studies
For the authors, the study shows that “Therapeutic decisions must take into account not only tumor biology, but also age, fragility and expectations of patients” and incite “To revise the way in which standards established in younger subjects are then applied to older subjects no significant benefit chemotherapy hormonosensible without high level of evidence or with little safeguards”.
In addition. these results “Call on favoring a reasoned therapeutic de -escalation strategy in these elderly patients, reserving chemotherapy adjuvant for specific cases. They also open the way to future research on better tolerated alternatives. such as adjuvant bisphosphonates, CDK4/6 inhibitors, or approaches incorporating the patient’s aging biomarkers. ”
“This collective work will make it possible to reduce unnecessary treatments. to improve the quality of life of elderly patients, based on robust data and representative of real life”, said Professor Jean-Yves Blay, president of Unicancer. And Professor Steven Le Gouill. director of the hospital ensemble of the Institut Curie, to point out that “ The oldest patients are often excluded from major studies ”.
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