ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Low-Intensity Adjuvant Chemotherapy for Breast Cancer in Older Women: Results From the Prospective Multicenter HOPE Trial.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed.
- Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Age, Body Mass Index, Tumor Subtype, and Racial and Ethnic Disparities in Breast Cancer Survival.JAMA network open · 2023Trial
- Association between antibiotic use and pathologic response to neoadjuvant chemotherapy in breast cancer: a multicentre retrospective cohort study.Breast (Edinburgh, Scotland) · 2026Article
- Early discontinuation of chemotherapy in older adults with early breast cancer: results from the prospective multicenter HOPE study.Journal of the National Cancer Institute · 2026Article
- Personalizing cancer care for older adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Epigenetic age acceleration measures and chemotoxicity in older adults with early breast cancer.GeroScience · 2026Article
- Associations between age and chemotherapy dose reductions in women with stage I-IIIA breast cancer.Journal of the National Cancer Institute · 2026Article
- Body composition-based nutritional status during neoadjuvant chemotherapy and its association with relative dose intensity and hematologic toxicity in patients with gastric cancer.Frontiers in nutrition · 2026Article
- Effectiveness of Compression Therapy for the Prevention of Taxane-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis.Journal of pain research · 2026Review
- Impact of relative dose intensity of first-line platinum-based chemotherapy in patients with thymic epithelial tumors: a retrospective study.Therapeutic advances in medical oncology · 2026Article
- Challenging the age barrier: comparative outcomes in octogenarian and non-octogenarian colorectal cancer patients.BMC geriatrics · 2025Article
- The timing of surgery for elderly patients with locally advanced breast cancer.Translational cancer research · 2025Article
- Patterns of presentation, treatment, and survival among older adults with metastatic breast cancer: Results from a large prospective registry.Journal of geriatric oncology · 2025Article
- A Nomogram Incorporating Intermuscular Adipose Tissue to Predict Chemotherapy Toxicity in Older Adults With Early-Stage Breast Cancer.Journal of breast cancer · 2025Article
- Article
- Breast Cancer in Older Patients Aged 70 Years and Above: Treatment Adherence and Oncologic Outcomes.Journal of breast cancer · 2025Article
- Methodologic Approach to Defining Comorbidities in a Cohort of Patients With Cancer: An Example in the Optimal Breast Cancer Chemotherapy Dosing Study.JCO clinical cancer informatics · 2025Article
- Chemotherapy in older patients with early breast cancer.Breast (Edinburgh, Scotland) · 2024Review
- Racial Disparities in Receipt of Guideline-Concordant Care in Older Adults With Early Breast Cancer.JAMA network open · 2024Article
- Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study.Journal of cancer survivorship : research and practice · 2024Observational
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Authors and funding
21 authors.
Funding
Abstract
purposeOlder women with high-risk early breast cancer (EBC) benefit from adjuvant chemotherapy, but their treatment is frequently complicated by toxic side effects, resulting in dose reductions and delays. This makes it challenging for oncologists to maintain a relative dose intensity (RDI) ≥ 85%, as recommended for optimal curative-intent treatment. Understanding which women are at risk of receiving suboptimal RDI may inform treatment discussions and guide early, targeted supportive care or geriatric comanagement interventions.
methodsThis was a prespecified secondary analysis of the HOPE trial, which enrolled women age ≥ 65 years with EBC initiating neoadjuvant or adjuvant chemotherapy. RDI was calculated as the ratio of delivered to planned chemotherapy dose intensity. The primary outcome was low RDI, defined as RDI < 85%. Multivariable logistic regression with stepwise selection was used to evaluate the association between baseline variables (demographic, clinical, and geriatric assessment) and low RDI. Survival probability was estimated using the Kaplan-Meier method, and the log-rank test was used to compare overall survival.
resultsThree hundred twenty-two patients (median age at diagnosis, 70 years; range, 65-86 years) were included. The median follow-up was 4 years. Sixty-six patients (21%) had a low RDI. Age ≥ 76 years (odds ratio [OR], 2.57; 95% CI, 1.12 to 5.91;
conclusionOne in five older patients with EBC treated with standard chemotherapy received low RDI and had inferior survival outcomes. Older patients at risk for low RDI should be identified and targeted upfront before initiating chemotherapy.
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