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

Diana Crivellari, Kathryn P. Gray, Silvia Dellapasqua, Fabio Puglisi, Karin Ribi, Karen N. Price, István Láng, Lorenzo Gianni, Simon Spazzapan, Graziella Pinotti, Jean Marc Lüthi, Richard D. Gelber, Meredith M. Regan, Marco Colleoni, Monica Castiglione-Gertsch, Rudolf Maibach, Manuela Rabaglio, Alan S. Coates, Aron Goldhirsch

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29 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)130-137
Number of pages8
JournalBreast
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Adjuvant treatment
  • Breast cancer
  • Chemotherapy
  • Elderly
  • Endocrine nonresponsive
  • Pegylated liposomal doxorubicin

ASJC Scopus subject areas

  • Surgery

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  • Cite this

    Crivellari, D., Gray, K. P., Dellapasqua, S., Puglisi, F., Ribi, K., Price, K. N., Láng, I., Gianni, L., Spazzapan, S., Pinotti, G., Lüthi, J. M., Gelber, R. D., Regan, M. M., Colleoni, M., Castiglione-Gertsch, M., Maibach, R., Rabaglio, M., Coates, A. S., & Goldhirsch, A. (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), 130-137. https://doi.org/10.1016/j.breast.2013.01.015