Optimizing the use of anthracyclines in older patients with breast cancer.
Recently, a greater understanding of tumor biology, including the use of genetic signatures, has led to a more precise classification of breast cancer. This has translated into a more granular assessment of risk-benefit calculations for the selection of patients for adjuvant therapies. For unselected patients, anthracyclines offer a survival benefit over non-anthracycline-based regimens, but are associated with long-term risks including congestive heart failure. Until recently, the benefit of anthracyclines in older patients with early breast cancer was largely extrapolated from studies involving younger cohorts. Emerging data now suggest that for appropriately selected older patients anthracyclines offer distinct benefits and are associated with a manageable toxicity profile. This review will focus on the benefits and risks of anthracyclines in older patients with various subtypes of breast cancer.
Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 475 New York NY 10065, USA.
Patrick G
PG
Morris
Monica N
MN
Fornier
D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism
D018943:Anthracyclines; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human