Clinical feasibility of (neo)adjuvant taxane-based chemotherapy in older patients: analysis of > 4,500 patients from four German randomized breast cancer trials

Introduction Despite the fact that people older than 65 years of
age have the highest incidence of developing breast cancer, these
patients are excluded from clinical trials in most cases.
Furthermore, most physicians tend towards therapy regimens without
the use of dose-dense, highly active taxane-based treatments
because of a lack of data regarding toxicities of these compounds
in older patients. Methods Pooled side-effect data were analyzed
from four prospective, randomized clinical trials in which patients
of different age groups (60 years, between 60 and 64 years, and 64
years) with primary breast cancer received taxane-based
chemotherapy. Results Dose delays, dose reductions,
hospitalization, and therapy discontinuation increased with age.
Hematologic toxicities and some nonhematologic toxicities were
generally more common in older patients. Leucopenia increased from
55.3% in patients aged 60 years to 65.5% in patients aged 64 years
(P