Multicenter study of risk factors for low-intensity adjuvant chemotherapy for breast cancer in older women

Older 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. Secondary analysis of the prospective HOPE trial found relative dose intensity lower than 85% in 21% of older (aged 65-85 year) EBC patients. Risk factors for low RDI were age 76 years or higher, low perfomance status, and use of anthracycline-based or cyclophosphamide-methotrexate-fluorouracil regimens. Five-year overall survival probability was 80% among patients receiving RDI < 85%, compared with 91% among patients receiving RDI ≥ 85% (p=0.02).