2022
Treatment discontinuation, patient-reported toxicities and quality-of-life by age following trastuzumab emtansine or paclitaxel/trastuzumab (ATEMPT)
Sella T, Zheng Y, Tayob N, Ruddy K, Freedman R, Dang C, Yardley D, Isakoff S, Valero V, DeMeo M, Burstein H, Winer E, Wolff A, Krop I, Partridge A, Tolaney S. Treatment discontinuation, patient-reported toxicities and quality-of-life by age following trastuzumab emtansine or paclitaxel/trastuzumab (ATEMPT). Npj Breast Cancer 2022, 8: 127. PMID: 36450763, PMCID: PMC9712612, DOI: 10.1038/s41523-022-00495-x.Peer-Reviewed Original ResearchHER2-positive breast cancerPatient-reported toxicityPatient-reported outcomesT-DM1Treatment discontinuationTrastuzumab emtansineBreast cancerStage I HER2-positive breast cancerAdjuvant trastuzumab emtansineExcellent disease outcomesLess activity impairmentPaclitaxel/trastuzumabSocial/familyPositive breast cancerSuperior QoLOlder patientsTreatment toleranceTreatment armsTreatment regimensEligible participantsGlobal QoLTherapy optionsActivity impairmentMultivariable modelDisease outcome
2021
Individualizing Surveillance Mammography for Older Patients After Treatment for Early-Stage Breast Cancer
Freedman RA, Minami CA, Winer EP, Morrow M, Smith AK, Walter LC, Sedrak MS, Gagnon H, Perilla-Glen A, Wildiers H, Wildes TM, Lichtman SM, Loh KP, Brain EGC, Ganschow PS, Hunt KK, Mayer DK, Ruddy KJ, Jagsi R, Lin NU, Canin B, LeStage BK, Revette AC, Schonberg MA, Keating NL. Individualizing Surveillance Mammography for Older Patients After Treatment for Early-Stage Breast Cancer. JAMA Oncology 2021, 7: 609-615. PMID: 33507222, PMCID: PMC8944384, DOI: 10.1001/jamaoncol.2020.7582.Peer-Reviewed Original ResearchConceptsBreast cancer survivorsBreast cancer eventsContralateral breast cancer eventsOlder breast cancer survivorsSurveillance mammographyClinician focus groupsCancer survivorsConsensus guidelinesCancer eventsLife expectancyEarly-stage breast cancerRoutine surveillance mammographyHigh-risk cancerClinical breast examinationExpert panelMultidisciplinary expert panelExpert consensus guidelinesIndividualized discussionGeriatric oncologyOlder patientsRoutine mammographyClinical findingsBreast examinationPatient preferencesPatient risk
2020
Weathering the Storm: Managing Older Adults With Breast Cancer Amid COVID-19 and Beyond
Freedman RA, Sedrak MS, Bellon JR, Block CC, Lin NU, King TA, Minami C, VanderWalde N, Jolly TA, Muss HB, Winer EP. Weathering the Storm: Managing Older Adults With Breast Cancer Amid COVID-19 and Beyond. Journal Of The National Cancer Institute 2020, 113: 355-359. PMID: 32449757, PMCID: PMC7313961, DOI: 10.1093/jnci/djaa079.Peer-Reviewed Original ResearchConceptsOlder patientsBreast cancerSevere acute respiratory syndrome coronavirus 2 exposureTreatment-related toxicityMultidisciplinary treatment approachBreast cancer patientsUnique clinical considerationsCOVID-19Chemotherapy toxicityMetastatic diseaseTreatment delayCancer patientsFunctional statusCare considerationsTreatment decisionsFunctional declineTherapeutic benefitTreatment prioritiesClinical considerationsTreatment approachesPatientsOlder adultsCOVID-19 pandemicCancerToxicity
2018
Breast cancer‐specific survival by age: Worse outcomes for the oldest patients
Freedman RA, Keating NL, Lin NU, Winer EP, Vaz‐Luis I, Lii J, Exman P, Barry WT. Breast cancer‐specific survival by age: Worse outcomes for the oldest patients. Cancer 2018, 124: 2184-2191. PMID: 29499074, PMCID: PMC5935594, DOI: 10.1002/cncr.31308.Peer-Reviewed Original ResearchConceptsBreast cancer-specific deathCancer-specific deathTriple-negative diseaseHuman epidermal growth factor receptor 2Epidermal growth factor receptor 2Growth factor receptor 2Breast cancer outcomesOlder patientsFactor receptor 2Breast cancerCancer outcomesReceptor 2Disease subtypesWorse breast cancer outcomesHR-positive diseaseCancer stage IEnd Results (SEER) dataAmerican Joint CommitteePopulation-based cohortStage of diseaseGray regression modelsAdjusted hazardClinical variablesDisease stageHigh risk
2017
Lymphedema, musculoskeletal events and arm function in older patients receiving adjuvant chemotherapy for breast cancer (Alliance A171302)
Hopkins JO, Allred J, Hurria A, Jatoi A, Lafky JM, Cohen H, Hudis C, Winer E, Mandelblatt J, Partridge A, Carey L, Muss HB. Lymphedema, musculoskeletal events and arm function in older patients receiving adjuvant chemotherapy for breast cancer (Alliance A171302). Breast Cancer Research And Treatment 2017, 166: 793-808. PMID: 28825227, PMCID: PMC5771504, DOI: 10.1007/s10549-017-4454-7.Peer-Reviewed Original ResearchConceptsQuality of lifeArm functionBreast cancerAdjuvant chemotherapyMusculoskeletal eventsPhysician-reported adverse eventsIncidence of lymphedemaAxillary node dissectionType of chemotherapyEORTC QLQ-BR23Breast cancer treatmentImpact of treatmentDetection of lymphedemaCALGB 49907Node dissectionAdverse eventsOlder patientsQLQ-BR23Standard therapyStudy entryWomen 65Month 2Elderly womenPatientsChemotherapyFrailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance)
Mandelblatt JS, Cai L, Luta G, Kimmick G, Clapp J, Isaacs C, Pitcher B, Barry W, Winer E, Sugarman S, Hudis C, Muss H, Cohen HJ, Hurria A. Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance). Breast Cancer Research And Treatment 2017, 164: 107-117. PMID: 28364214, PMCID: PMC5479131, DOI: 10.1007/s10549-017-4222-8.Peer-Reviewed Original ResearchConceptsOlder breast cancer patientsLong-term mortalityBreast cancer patientsCancer patientsHormonal therapyRobust patientsFrailty indexBreast cancer-specific mortalityDeficit-accumulation frailty indexAbsolute mortality differencePurposeBreast cancer patientsAdjusted hazard ratioCancer-specific mortalityBreast cancer deathsInvasive breast cancerBreast cancer mortalityAdjusted hazardFrailty categoriesCause mortalityFrail patientsMore chemotherapyFrailty statusHazard ratioOlder patientsClinical factorsUsing ePrognosis to estimate 2-year all-cause mortality in older women with breast cancer: Cancer and Leukemia Group B (CALGB) 49907 and 369901 (Alliance A151503)
Kimmick GG, Major B, Clapp J, Sloan J, Pitcher B, Ballman K, Barginear M, Freedman RA, Artz A, Klepin HD, Lafky JM, Hopkins J, Winer E, Hudis C, Muss H, Cohen H, Jatoi A, Hurria A, Mandelblatt J. Using ePrognosis to estimate 2-year all-cause mortality in older women with breast cancer: Cancer and Leukemia Group B (CALGB) 49907 and 369901 (Alliance A151503). Breast Cancer Research And Treatment 2017, 163: 391-398. PMID: 28283904, PMCID: PMC5508575, DOI: 10.1007/s10549-017-4188-6.Peer-Reviewed Original ResearchConceptsMortality rateBreast cancerNon-cancer mortality risksOlder breast cancer patientsStage I-IIA diseaseTwo-year mortality rateAdjuvant therapy decisionsResultsPatients' mean ageCooperative group studiesKaplan-Meier methodOverall survival estimatesBreast cancer patientsAvailable clinical informationCommunity-dwelling eldersObserved mortality rateBreast Cancer StudyAdjuvant therapyCause mortalityMost patientsOlder patientsBetter prognosisWorse prognosisPoor prognosisTrial populationMean ageSurveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?: A Review
Freedman RA, Keating NL, Partridge AH, Muss HB, Hurria A, Winer EP. Surveillance Mammography in Older Patients With Breast Cancer—Can We Ever Stop?: A Review. JAMA Oncology 2017, 3: 402-409. PMID: 27892991, PMCID: PMC5540165, DOI: 10.1001/jamaoncol.2016.3931.Peer-Reviewed Original ResearchConceptsBreast cancer survivorsSurveillance mammographyAnticipated life expectancyOlder patientsBreast eventsBreast cancerCancer survivorsOlder survivorsHormonal therapyLife expectancyContralateral breast cancer riskOlder breast cancer survivorsAnnual surveillance mammographyIndividual riskPatient's individual riskCancer-related causesResidual breast tissueWomen 70 yearsBreast cancer riskBreast cancer screeningContralateral cancerMammographic surveillanceLocal therapyHealthy womenCancer screening
2016
Accrual of Older Patients With Breast Cancer to Alliance Systemic Therapy Trials Over Time: Protocol A151527
Freedman RA, Foster JC, Seisler DK, Lafky JM, Muss HB, Cohen HJ, Mandelblatt J, Winer EP, Hudis CA, Partridge AH, Carey LA, Cirrincione C, Moreno-Aspitia A, Kimmick G, Jatoi A, Hurria A. Accrual of Older Patients With Breast Cancer to Alliance Systemic Therapy Trials Over Time: Protocol A151527. Journal Of Clinical Oncology 2016, 35: 421-431. PMID: 27992272, PMCID: PMC5455700, DOI: 10.1200/jco.2016.69.4182.Peer-Reviewed Original ResearchConceptsOlder patientsMetastatic trialsAdjuvant trialsBreast cancerHormone receptor-negative tumorsBreast cancer treatment trialConclusion Older patientsSystemic therapy trialsReceptor-negative tumorsBreast cancer trialsCancer treatment trialsYears of ageAccrual challengesNeoadjuvant trialsAdjuvant studiesPatient ageTherapy cessationLymph nodesTherapeutic trialsTreatment cessationTumor sizeDisease characteristicsPatient populationTreatment trialsCancer trialsRisk of acute myeloid leukemia and myelodysplastic syndrome among older women receiving anthracycline-based adjuvant chemotherapy for breast cancer on Modern Cooperative Group Trials (Alliance A151511)
Freedman RA, Seisler DK, Foster JC, Sloan JA, Lafky JM, Kimmick GG, Hurria A, Cohen HJ, Winer EP, Hudis CA, Partridge AH, Carey LA, Jatoi A, Klepin HD, Citron M, Berry DA, Shulman LN, Buzdar AU, Suman VJ, Muss HB. Risk of acute myeloid leukemia and myelodysplastic syndrome among older women receiving anthracycline-based adjuvant chemotherapy for breast cancer on Modern Cooperative Group Trials (Alliance A151511). Breast Cancer Research And Treatment 2016, 161: 363-373. PMID: 27866278, PMCID: PMC5226883, DOI: 10.1007/s10549-016-4051-1.Peer-Reviewed Original ResearchConceptsAML/MDSAcute myeloid leukemiaOlder patientsAdjuvant chemotherapyMyeloid leukemiaBreast cancerAnthracycline-based adjuvant chemotherapyMultivariable Cox regressionCooperative group trialsEffect of cyclophosphamideRace/ethnicityAnthracycline usePerformance statusCox regressionMyelodysplastic syndromeClinical trialsGroup trialsOlder womenOncology trialsPatientsStudy registrationOlder ageAnthracyclinesCancerAgeTreatment of early-stage human epidermal growth factor 2-positive cancers among medicare enrollees: age and race strongly associated with non-use of trastuzumab
Vaz-Luis I, Lin NU, Keating NL, Barry WT, Lii J, Burstein HJ, Winer EP, Freedman RA. Treatment of early-stage human epidermal growth factor 2-positive cancers among medicare enrollees: age and race strongly associated with non-use of trastuzumab. Breast Cancer Research And Treatment 2016, 159: 151-162. PMID: 27484879, DOI: 10.1007/s10549-016-3927-4.Peer-Reviewed Original ResearchConceptsAdjuvant trastuzumabOlder patientsSystemic treatmentBreast cancerHuman epidermal growth factor receptor 2HER2-positive breast cancerEpidermal growth factor receptor 2HER2-positive diseaseStage III diseaseCongestive heart failureGrowth factor receptor 2Positive breast cancerFactor receptor 2Treatment omissionEndocrine therapyClinical characteristicsSystemic therapyHeart failureBlack patientsTreatment disparitiesTreatment patternsHuman epidermal growth factorEpidermal growth factorMedicare dataPatientsAccrual of older patients (pts) with breast cancer to Alliance systemic therapy trials over time: A151527.
Freedman R, Seisler D, Foster J, Lafky J, Kimmick G, Jatoi A, Muss H, Cohen H, Mandelblatt J, Winer E, Hudis C, Cirrincione C, Moreno-Aspitia A, Hurria A. Accrual of older patients (pts) with breast cancer to Alliance systemic therapy trials over time: A151527. Journal Of Clinical Oncology 2016, 34: 1024-1024. DOI: 10.1200/jco.2016.34.15_suppl.1024.Peer-Reviewed Original ResearchAcademic and Community Cancer Research United (ACCRU) RU011301I: Adjuvant ado-trastuzumab emtansine (T-DM1) for older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer.
Freedman R, Polley M, Dueck A, Hurria A, Muss H, Ruddy K, Hubbard J, Liu H, Rogak L, Basch E, Dakhil S, Huff J, Bajaj M, Wilkinson M, Al Baghadadi T, Benjamin S, Mowat R, Hudis C, Rugo H, Winer E. Academic and Community Cancer Research United (ACCRU) RU011301I: Adjuvant ado-trastuzumab emtansine (T-DM1) for older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Journal Of Clinical Oncology 2016, 34: tps629-tps629. DOI: 10.1200/jco.2016.34.15_suppl.tps629.Peer-Reviewed Original Research
2014
Frailty and Adherence to Adjuvant Hormonal Therapy in Older Women With Breast Cancer: CALGB Protocol 369901
Sheppard VB, Faul LA, Luta G, Clapp JD, Yung RL, Wang JH, Kimmick G, Isaacs C, Tallarico M, Barry WT, Pitcher BN, Hudis C, Winer EP, Cohen HJ, Muss HB, Hurria A, Mandelblatt JS. Frailty and Adherence to Adjuvant Hormonal Therapy in Older Women With Breast Cancer: CALGB Protocol 369901. Journal Of Clinical Oncology 2014, 32: 2318-2327. PMID: 24934786, PMCID: PMC4105485, DOI: 10.1200/jco.2013.51.7367.Peer-Reviewed Original ResearchConceptsAdjuvant hormonal therapyHormonal therapyBreast cancerOlder womenInfluence of frailtyCovariate adjustmentRisk of discontinuationNonmetastatic breast cancerBreast cancer ageProportional hazards modelIIB diseaseEarly discontinuationMost patientsOlder patientsProspective cohortBaseline frailtyCancer ageHigher oddsDiscontinuationHazards modelMost womenPsychosocial dataNoninitiationTherapyLogistic regressionPatterns of chemotherapy, toxicity, and short-term outcomes for older women receiving adjuvant trastuzumab-based therapy
Freedman RA, Vaz-Luis I, Barry WT, Lii H, Lin NU, Winer EP, Keating NL. Patterns of chemotherapy, toxicity, and short-term outcomes for older women receiving adjuvant trastuzumab-based therapy. Breast Cancer Research And Treatment 2014, 145: 491-501. PMID: 24756187, DOI: 10.1007/s10549-014-2968-9.Peer-Reviewed Original ResearchConceptsNon-standard chemotherapyTrastuzumab-based therapyAdjuvant trastuzumab-based therapyOlder womenChemotherapy receiptHazard ratioBreast cancerHER2-positive breast cancerPattern of chemotherapyPropensity-weighted cohortsToxicity-related hospitalizationAdjusted hazard ratioTreatment-related toxicityMonths of chemotherapyShort-term outcomesMultivariable logistic regressionPopulation-based cohortPropensity score adjustmentAssociation of ageShort-term survivalComorbidity scoreOlder patientsTreatment toxicityWorse survivalHospital eventsDuration and Toxicity of Adjuvant Trastuzumab in Older Patients With Early-Stage Breast Cancer: A Population-Based Study
Vaz-Luis I, Keating NL, Lin NU, Lii H, Winer EP, Freedman RA. Duration and Toxicity of Adjuvant Trastuzumab in Older Patients With Early-Stage Breast Cancer: A Population-Based Study. Journal Of Clinical Oncology 2014, 32: 927-934. PMID: 24516021, PMCID: PMC3948095, DOI: 10.1200/jco.2013.51.1261.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerCardiac eventsOlder patientsBreast cancerTrastuzumab completionAdjuvant trastuzumabTreatment completionOlder womenHuman epidermal growth factor receptorAdjuvant trastuzumab useAge 76 yearsDays of therapyMost older patientsSignificant cardiac eventsMultivariable logistic regressionEpidermal growth factor receptorGrowth factor receptorMore comorbiditiesTrastuzumab useComorbidity scorePatient ageHospital admissionOptimal treatmentLower oddsMedicare data
2013
A planned, prospective comparison of short-term quality of life outcomes among older patients with breast cancer treated with standard chemotherapy in a randomized clinical trial vs. an observational study: CALGB #49907 and #369901
Mandelblatt JS, Makgoeng SB, Luta G, Hurria A, Kimmick G, Isaacs C, Tallarico M, Barry WT, Pitcher B, Winer EP, Hudis C, Cohen HJ, Muss HB. A planned, prospective comparison of short-term quality of life outcomes among older patients with breast cancer treated with standard chemotherapy in a randomized clinical trial vs. an observational study: CALGB #49907 and #369901. Journal Of Geriatric Oncology 2013, 4: 353-361. PMID: 24472479, PMCID: PMC3910230, DOI: 10.1016/j.jgo.2013.05.004.Peer-Reviewed Original ResearchConceptsRandomized clinical trialsOlder womenStandard chemotherapyClinical trialsProspective comparisonObservational studyBreast cancerNon-metastatic breast cancerOlder cancer populationPre-treatment QoLTherapy side effectsBreast cancer chemotherapyShort-term qualityAdjusted mean increaseQuality of lifeTumor factorsOlder patientsAnthracycline regimensQOL scoresGlobal QoLCancer populationSide effectsGroup physiciansChemotherapyLinear mixed effects modelsCompletion of adjuvant trastuzumab for older patients with early-stage breast cancer (BC).
Freedman R, Luis I, Lin N, Lii J, Winer E, Keating N. Completion of adjuvant trastuzumab for older patients with early-stage breast cancer (BC). Journal Of Clinical Oncology 2013, 31: 616-616. DOI: 10.1200/jco.2013.31.15_suppl.616.Peer-Reviewed Original ResearchEarly-stage breast cancerBreast cancerAdjuvant trastuzumabCardiac eventsOlder womenTrastuzumab completionOlder patientsHospital admissionDays of therapyTaxane-based therapyMultivariable logistic regressionMore comorbiditiesLower oddsHispanic womenMedicare dataTrastuzumabPatientsTherapyLogistic regressionWomenComorbiditiesChemotherapyAdmissionOne-quarterTreatment
2012
Persistence, adherence, and toxicity with oral CMF in older women with early-stage breast cancer (Adherence Companion Study 60104 for CALGB 49907)
Ruddy KJ, Pitcher BN, Archer LE, Cohen HJ, Winer EP, Hudis CA, Muss HB, Partridge AH. Persistence, adherence, and toxicity with oral CMF in older women with early-stage breast cancer (Adherence Companion Study 60104 for CALGB 49907). Annals Of Oncology 2012, 23: 3075-3081. PMID: 22767584, PMCID: PMC3501229, DOI: 10.1093/annonc/mds133.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerBreast cancerMedication calendarOral cyclophosphamideStandard chemotherapyStage I-IIIB breast cancerSelf-reported adherenceCase report formsToxic effectsAdjuvant chemotherapyCALGB 49907Febrile neutropeniaOral CMFNode negativityOlder patientsStandard therapyMedian ageSuperior tolerabilityRandomized trialsCyclophosphamide dosesAverage adherenceOlder womenCyclophosphamideChemotherapyConsecutive days
2011
Paclitaxel efficacy and toxicity in older women with metastatic breast cancer: combined analysis of CALGB 9342 and 9840
Lichtman S, Hurria A, Cirrincione C, Seidman A, Winer E, Hudis C, Cohen H, Muss H, B F. Paclitaxel efficacy and toxicity in older women with metastatic breast cancer: combined analysis of CALGB 9342 and 9840. Annals Of Oncology 2011, 23: 632-638. PMID: 21693770, PMCID: PMC3331731, DOI: 10.1093/annonc/mdr297.Peer-Reviewed Original ResearchConceptsProgression-free survivalGood performance statusFirst-line therapyMetastatic breast cancerOverall survivalPerformance statusBreast cancerOlder womenLeukemia Group B StudySecond-line therapyImproved overall survivalDoses of paclitaxelEstrogen receptor-positive statusTolerability of paclitaxelToxic effectsBilirubin elevationPaclitaxel efficacyWeekly paclitaxelOlder patientsMetastatic sitesTumor responseSimilar efficacyPositive statusSpecific toxic effectsPatients