ArticleBMC medicine2015
A nested cohort study of 6,248 early breast cancer patients treated in neoadjuvant and adjuvant chemotherapy trials investigating the prognostic value of chemotherapy-related toxicities.
Article in BMC medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 32 citations in OpenAlex.
- Trial
- The Relationship between Common Genetic Markers of Breast Cancer Risk and Chemotherapy-Induced Toxicity: A Case-Control Study.PloS one · 2016Trial
- Retrospective analysis of the clinical efficacy of neoadjuvant chemotherapy albumin paclitaxel combined with carboplatin in the treatment of triple-negative breast cancer.Scientific reports · 2025Article
- CYP2D6 and CYP2E1 Gene Polymorphisms and Their Influence on Chemotherapy Treatment Outcome and Toxicity in Breast Cancer Patients.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Visceral Adipose Predicts Prognosis and Toxicities in Locally Advanced Bladder Cancer Patients Treated With Adjuvant Gemcitabine Plus Cisplatin Chemotherapy.Cancer medicine · 2025Article
- Harnessing physical activity monitoring and digital biomarkers of frailty from pendant based wearables to predict chemotherapy resilience in veterans with cancer.Scientific reports · 2024Article
- Incidence, consequences, and predictors of serious chemotherapy-induced thrombocytopenia in nasopharyngeal carcinoma.Cancer medicine · 2023Article
- Obesity reduced survival with 5-fluorouracil and did not protect against chemotherapy-induced cachexia or immune cell cytotoxicity in mice.Cancer biology & therapy · 2022Article
- Chemotherapy-Induced Toxicities and Their Associations with Clinical and Non-Clinical Factors among Breast Cancer Patients in Vietnam.Current oncology (Toronto, Ont.) · 2022Article
- 5-Fluorouracil disrupts skeletal muscle immune cells and impairs skeletal muscle repair and remodeling.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
- Racial disparity in taxane-induced neutropenia among cancer patients.Cancer medicine · 2021Article
- A study of the efficacy and tolerability of capecitabine and lobaplatin in advanced HER-2 negative breast cancer patients.Annals of translational medicine · 2021Article
- Leukocyte kinetics during the first cycle of chemotherapy predicts the outcome of patients with metastatic colorectal cancer and previous resection of the primary tumor.International journal of colorectal disease · 2021Article
- Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer.Journal of traditional and complementary medicine · 2021Article
- The Acute Effects of 5 Fluorouracil on Skeletal Muscle Resident and Infiltrating Immune Cells in Mice.Frontiers in physiology · 2020Article
- The Impact of Immune Cells on the Skeletal Muscle Microenvironment During Cancer Cachexia.Frontiers in physiology · 2020Review
- Article
- Prognostic factors influencing prognosis in early breast cancer patients.Przeglad menopauzalny = Menopause review · 2019Article
- Pathological significance of MAD2L1 in breast cancer: an immunohistochemical study and meta analysis.International journal of clinical and experimental pathology · 2017Article
- Complete and Sustained Response with a Doublet Chemotherapy Protocol in an 81-Year-Old Patient with Metastatic Breast Cancer.Case reports in oncologyArticle
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe relationship between chemotherapy-related toxicities and prognosis is unclear. Previous studies have examined the association of myelosuppression parameters or neuropathy with survival and reported conflicting results. This study aims to investigate 13 common chemotherapy toxicities and their association with relapse-free survival and breast cancer-specific survival.
methodsChemotherapy-related toxicities were collected prospectively for 6,248 women with early-stage breast cancer from four randomised controlled trials (NEAT; BR9601; tAnGo; Neo-tAnGo). Cox proportional-hazards modelling was used to analyse the association between chemotherapy-related toxicities and both breast cancer-specific survival and relapse-free survival. Models included important prognostic factors and stratified by variables violating the proportional hazards assumption.
resultsMultivariable analysis identified severe neutropenia (grades ≥3) as an independent predictor of relapse-free survival (hazard ratio (HR) = 0.86; 95% confidence interval (CI), 0.76-0.97; P = 0.02). A similar trend was seen for breast cancer-specific survival (HR = 0.87; 95% CI, 0.75-1.01; P = 0.06). Normal/low BMI patients experienced more severe neutropenia (P = 0.008) than patients with higher BMI. Patients with fatigue (grades ≥3) showed a trend towards reduced survival (breast cancer-specific survival: HR = 1.17; 95% CI, 0.99-1.37; P = 0.06). In the NEAT/BR9601 sub-group analysis by treatment component, this effect was statistically significant (HR = 1.61; 95% CI, 1.13-2.30; P = 0.009).
conclusionsThis large study shows a significant association between chemotherapy-induced neutropenia and increased survival. It also identifies a strong relationship between low/normal BMI and increased incidence of severe neutropenia. It provides evidence to support the development of neutropenia-adapted clinical trials to investigate optimal dose calculation and its impact on clinical outcome. This is important in populations where obesity may lead to sub-optimal chemotherapy doses.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.