Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are NOT suitable for a "standard chemotherapy regimen": the CASA randomized trial

Crivellari, Diana; Gray, Kathryn P.; Dellapasqua, Silvia; Puglisi, Fabio; Ribi, Karin; Price, Karen N.; Láng, István; Gianni, Lorenzo; Spazzapan, Simon; Pinotti, Graziella; Lüthi, Jean-Marc; Gelber, Richard D.; Regan, Meredith M; Colleoni, Marco; Castiglione-Gertsch, Monica; Maibach, Rudolf; Rabaglio, Manuela; Coates, Alan S.; Goldhirsch, Aron (2013). Adjuvant pegylated liposomal doxorubicin for older women with endocrine nonresponsive breast cancer who are NOT suitable for a "standard chemotherapy regimen": the CASA randomized trial. Breast, 22(2), pp. 130-137. Elsevier 10.1016/j.breast.2013.01.015

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There is no optimal treatment for breast cancers lacking estrogen (ER) and progesterone (PgR) receptors in elderly women with co-morbidities that prevent use of "standard chemotherapy regimens" such as AC or CMF. The CASA trial studied pegylated liposomal doxorubicin (PLD) and low dose, metronomic cyclophosphamide + methotrexate (CM) for older (>65), vulnerable women with operable, ER and PgR-negative breast cancer. After two years the trial closed early, due to slow and inadequate accrual, with 77 patients (38:PLD, 36:CM, 3:nil). Sixty-eight percent completed PLD; 83% completed CM (both 16 weeks). Patients on PLD reported worse quality of life, cognitive and physical functioning than non-PLD regimens (primarily CM). At a median follow-up of 42 months, 81% of randomized patients remained free of any breast cancer recurrence. Based on our limited experience, PLD and CM may be reasonable options for further study for elderly vulnerable patients with endocrine nonresponsive breast cancer.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
UniBE Contributor:	Rabaglio, Manuela Elena
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0960-9776
Publisher:	Elsevier
Language:	English
Submitter:	Marianne Zahn
Date Deposited:	18 Mar 2014 02:14
Last Modified:	02 Mar 2023 23:24
Publisher DOI:	10.1016/j.breast.2013.01.015
PubMed ID:	23453899
Uncontrolled Keywords:	Adjuvant treatment; Endocrine nonresponsive; Chemotherapy; Pegylated liposomal doxorubicin; Elderly; Breast cancer
URI:	https://boris.unibe.ch/id/eprint/45057