Chemotherapy-induced biological age acceleration and lifetime outcomes in breast cancer survivors

Growing evidence suggests that some breast cancer survivors may experience accelated aging (biological age in excess of chronological age) after receiving chemotherapy. A comparative effectiveness study quantified the range of lifetime changes in accelerated aging following chemotherapy. The study used an established population-level simulation model and current data on chemotherapy’s effect on cellular senescence to estimate differences in biological age acceleration in a simulated population of 400 US women diagnosed with breast cancer at ages 30 to 79 years between 1990 and 2030, with follow-up until death. The model estimated that breast cancer survivors who received anthracycline lost 9.4 years (IQR 7.6-11.2) of remaining life years. There was heterogeneity in results, with greater variability for women diagnosed at younger versus older ages. Women receiving more versus less cytotoxic regimens were estimated to lose a median difference of 7.6 more years of life (IQR 7.0-8.0) due to earlier ages at onset of aging-related diseases. The model closely replicated all-cause and 8-year breast cancer survival trends in the ABC trials. The authors conclude that these findings suggest that integrating knowledge about biological aging into survivorship care may help identify opportunities to deploy pharmaceutical and behavioral interventions that target aging-related processes.