Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Adjuvant Chemotherapy and Breast Cancer

What are the effects of delayed initiation?

Delaying initiation of adjuvant chemotherapy 91 or more days for patients with breast cancer can lead to adverse outcomes, especially among patients with triple-negative breast cancer. This according to a study of 24,843 patients with stage I to III invasive breast cancer and a median age at diagnosis of 53 years. Researchers found:

• Patients treated 91 or more days from surgery experienced worse overall survival (HR, 1.34) and worse breast cancer-specific survival (HR, 1.27).

• There was no evidence of adverse outcomes among patients with time to chemotherapy (TTC) of 31 to 60 days or 60 to 90 days.

• Longer TTC caused patients with triple-negative breast cancer to have worse overall survival (HR, 1.53) and worse breast cancer-specific survival (HR, 1.53).

Citation: Chavez-MacGregor M, Clarke CA, Lichtensztajn DY, Giordano SH. Delayed initiation of adjuvant chemotherapy among patients with breast cancer. [Published online ahead of print December 10, 2015]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.3856.