The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (alliance)

Ajeet Gajra, Linda McCall, Hyman B. Muss, Harvey J. Cohen, Aminah Jatoi, Karla V. Ballman, Ann H. Partridge, Linda Sutton, Barbara A. Parker, Gustav Magrinat, Heidi D. Klepin, Jacqueline M. Lafky, Arti Hurria

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47% had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95% vs. 78%, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53% vs. 34%, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.

Original languageEnglish (US)
JournalJournal of Geriatric Oncology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Breast Neoplasms
Drug Therapy
Neoplasms
Quality of Life
Therapeutics
Adjuvant Chemotherapy
Nausea
Vomiting
Survival
Patient Preference
Mental Health
Demography
Health

Keywords

  • Adjuvant chemotherapy
  • Breast cancer
  • Decision-making
  • Elderly

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology

Cite this

The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (alliance). / Gajra, Ajeet; McCall, Linda; Muss, Hyman B.; Cohen, Harvey J.; Jatoi, Aminah; Ballman, Karla V.; Partridge, Ann H.; Sutton, Linda; Parker, Barbara A.; Magrinat, Gustav; Klepin, Heidi D.; Lafky, Jacqueline M.; Hurria, Arti.

In: Journal of Geriatric Oncology, 01.01.2018.

Research output: Contribution to journalArticle

Gajra, A, McCall, L, Muss, HB, Cohen, HJ, Jatoi, A, Ballman, KV, Partridge, AH, Sutton, L, Parker, BA, Magrinat, G, Klepin, HD, Lafky, JM & Hurria, A 2018, 'The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (alliance)', Journal of Geriatric Oncology. https://doi.org/10.1016/j.jgo.2018.02.003
Gajra, Ajeet ; McCall, Linda ; Muss, Hyman B. ; Cohen, Harvey J. ; Jatoi, Aminah ; Ballman, Karla V. ; Partridge, Ann H. ; Sutton, Linda ; Parker, Barbara A. ; Magrinat, Gustav ; Klepin, Heidi D. ; Lafky, Jacqueline M. ; Hurria, Arti. / The preference to receive chemotherapy and cancer-related outcomes in older adults with breast cancer CALGB 49907 (alliance). In: Journal of Geriatric Oncology. 2018.
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abstract = "Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47{\%} had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95{\%} vs. 78{\%}, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53{\%} vs. 34{\%}, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.",
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AU - Gajra, Ajeet

AU - McCall, Linda

AU - Muss, Hyman B.

AU - Cohen, Harvey J.

AU - Jatoi, Aminah

AU - Ballman, Karla V.

AU - Partridge, Ann H.

AU - Sutton, Linda

AU - Parker, Barbara A.

AU - Magrinat, Gustav

AU - Klepin, Heidi D.

AU - Lafky, Jacqueline M.

AU - Hurria, Arti

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N2 - Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47% had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95% vs. 78%, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53% vs. 34%, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.

AB - Objective: Chemotherapy preference refers to a patient's interest in receiving chemotherapy. This study examined whether chemotherapy preference was associated with toxicity, efficacy, quality of life (QoL), and functional outcomes during and after completion of adjuvant chemotherapy in older women with breast cancer. Materials and Methods: This study is a secondary analysis of CALGB 49907, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in patients age 65 years or older with breast cancer. A subset of 145 patients completed a questionnaire to describe chemotherapy preference pre-treatment. The association of this pre-treatment preference with the patient's perception of self-health, predicted and actual QoL, patient- and professional-reported toxicity, mental health, self-rated function, and survival was studied during and after treatment. Results: The median age of patients was 71 years and 47% had a high preference for chemotherapy. On baseline demographics, the low preference group had a higher proportion of white patients (95% vs. 78%, p = 0.004). Before treatment, low chemotherapy preference was associated with greater nausea/vomiting (p = 0.008). Mid-treatment, low preference was associated with lower QoL, worse social, emotional and physical function (all p ≤ 0.02) and worse nausea/vomiting, cancer symptoms and financial worries (all p < 0.05). The association noted mid-treatment, resolved after treatment completion except with financial worries which persisted at 24 months. Low preference was associated with higher rates of grade 3–5 adverse events (53% vs. 34%, p = 0.02) but was not associated with survival. Conclusions: Low chemotherapy preference prior to treatment initiation was associated with lower QoL, worse physical symptoms and self-rated function and more adverse events mid-treatment. There is no association of chemotherapy preference with survival.

KW - Adjuvant chemotherapy

KW - Breast cancer

KW - Decision-making

KW - Elderly

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