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Tool Can Predict Chemo Toxicity for Seniors With Breast Cancer

WEDNESDAY, Jan. 20, 2021 -- For older patients with early-stage breast cancer, a score has been developed and validated for predicting grade 3 to 5 chemotherapy toxicity, according to a study published online Jan. 14 in the Journal of Clinical Oncology.

Allison Magnuson, D.O., from the University of Rochester in New York, and colleagues prospectively evaluated patients aged 65 years and older with stage I to III breast cancer treated with neoadjuvant or adjuvant chemotherapy for geriatric or clinical features predictive of grade 3 to 5 chemotherapy toxicity.

Forty-six percent of the 473 patients (283 in development and 190 in validation cohorts) developed grade 3 to 5 toxicities. The researchers identified eight independent predictors: anthracycline use, stage II or III, planned treatment duration of more than three months, abnormal liver function, low hemoglobin, falls, limited walking, and lack of social support. Low-, intermediate-, and high-risk groups were defined based on the risk scores for each patient. For these groups, the rates of grade 3 to 5 chemotherapy toxicity were 19, 54, and 87 percent, respectively, in the development cohort, and 27, 45, and 76 percent, respectively, in the validation cohort. The area under the receiver operating characteristic curve was 0.75 and 0.69 in the development and validation cohorts, respectively.

"We now can offer each elderly, early-stage breast cancer patient individualized toxicity information that could help align treatment with their goals for lifestyle, quality of life, longevity, and other priorities," a coauthor said in a statement.

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