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A B S T R A C T S
P007
DIFFERING BIOLOGY OF BREAST CANCER ACCORDING TO AGE
B. M. Syed
1
, A. R. Green
2
, I. O. Ellis
2
, K. L. Cheung
3,
*
1
Medical Research Centre, Liaquat University of Medical & Health
Sciences, Jamshoro, Pakistan,
2
Pathology,
3
Breast Surgery, University
of Nottingham, Nottingham, United Kingdom
Introduction:
Emerging evidence suggests that breast
cancer in the older population tends to have more favourable
biology
Objectives:
This study aimed to explore a possible differing
pattern of tumour biology according to age.
Methods:
The study included 2,383 women with T
0-2
N
0-1
M
0
breast carcinoma managed in a single institution in
Nottingham. Among these patients 575 were
70 years of age
derived from a consecutive series. The younger (<70 years)
patients (N=1808) were from a previously characterised,
consecutive series. All patients were treated by primary
surgery with tissue micro-arrays constructed from their
surgical specimens. Indirect immunohistochemsitry was
used for analysis of a panel of biomarkers.
Results:
There were age-related changes in the pattern of
positivity of ER, PR, HER4, E-Cadherin, Ki67, p53, CK5/6, CK7/8,
CK14, CK17, CK18 and bcl2. The following patterns were
observed:
1. a. A gradual rise starting at 40 years – ER, PgR, Muc1 and
CK18.
2. b. A gradual decline starting at 40 years – Ki67, HER2, CK17
and E-Cadherin.
3. c. A rise at 70 years – Bcl2, CK5/6 and CK 14.
4. d. Two peaks at 40/50 years and at 70 years – CK7/8, CK19,
HER4 and p53.
Conclusion:
Biology of breast cancer shows a differing
pattern according to age, with 40 and 70 years being key
milestones. The pattern suggests <40 years as representing an
aggressive phenotype,
70 years as favourable and between
40–70 years as the transition. Recognition of such pattern
supports the use of a personalised treatment approach based
on precision biological assessment.
Disclosure of interest:
None declared
Keywords:
Age, biology, breast cancer
P008
COMORBIDITY AND CORRELATION WITH ADJUVANT
CHEMOTHERAPY OUTCOMES IN PATIENTS WITH
COLORECTAL CANCER
C. Lund
1,
*, D. Nielsen
2
, C. Dehlendorff
3
, F. Rønholt
1
,
J. S. Johansen
2
, K. K. Vistisen
2
1
Department of Medicine,
2
Department of Oncology, Herlev
Hospital,
3
Danish Cancer Society Research Center, Danish Cancer
Society, Copenhagen, Denmark
Introduction:
Patients with comorbidity are less frequently
treated with adjuvant chemotherapy for their colorectal
cancer (CRC) than healthy patients (1) due to concerns on
toxicity and a possible interaction with the cancer (2,3).
We wanted to investigate the influence of comorbidity on
treatment outcomes.
Objectives:
We wanted to investigate the influence of
comorbidity on treatment outcomes.
Methods:
A retrospective analyses of 529 patients treated
with adjuvant chemotherapy (5-fluorouracil/capecitabine
+/÷ oxaliplatin) after surgery for stage II-III CRC, from 2001 to
2012. We analyzed the occurrence of comorbidity and their
correlation to toxicity with logistic regression, and to disease
free survival (DFS), overall survival (OS) and CRC-mortality
with Cox proportional hazard regression.
Results:
Elderly patients (
70 years, N=191) had significantly
more hypertension (p=<0.01), hypercholesterolemia (p=0.04),
cardiovascular diseases (p<0.01), other cancers (p<0.01) and
other comorbidities (p<0.01) than younger patients (
70 years,
N=338).
Comorbidity was independently of age correlated with
shorter DFS: hypertension (HR 1.36 (95% CI 1.05-1.77), p=0.02),
MI (HR 2.10 (1.14-3.88), p=0.02), diabetes (HR 1.76 (1.21-2.57),
p<0.01), inflammatory diseases (HR 2.12 (1.36-3.32), p<0.01)
and other cancers (HR 1.72 (1.21-2.47), p=0.00). Comorbidity
was also independently of age correlated with shorter OS:
MI (HR 2.99 (1.66-5.38), p<0.01), diabetes (HR 1.99 (1.34-2.94),
p<0.01), inflammatory diseases (HR 2.07 (1.29-3.31), p<0.01)
and other cancers (HR 1.82 (1.25-2.64), p<0.01) and with higher
CRC-mortality: MI (HR 3.69 (1.93-7.06), p<0.01), inflammatory
diseases (HR 1.91 (1.02-3.52), p=0.04) and other cancers (HR
1.68 (1.03-2.72), p=0.04). None of the comorbidities were
statistically significant correlated with severe toxicity.
Conclusion:
In patients operated for stage II-III CRC
and treated with adjuvant chemotherapy we found that
hypertension, cardio-vascular disease, diabetes, and
inflammatory diseases and other cancers were independently
of age correlated with shorter DFS and OS. Earlier MI,
inflammatory diseases and other cancer were also correlated
with higher CRC related mortality.
References:
[1] Sanoff HK, Carpenter WR, Sturmer T et al. Effect of
adjuvant chemotherapy on survival of patients with stage
III colon cancer diagnosed after age 75 years. J Clin Oncol
2012;30:2624-2634.
[2] Hermosillo-Rodriguez J, Anaya DA, Sada Y, Walder A,
Amspoker AB, Berger DH, Naik AD: The effect of age
and comorbidity on patient-centered health outcomes
in patients receiving adjuvant chemotherapy for colon
cancer. J Geriatr Oncol 2013;4(2):99-106.
[3] Hu CY, Chan W, Delclos GP, Du XL: Adjuvant chemotherapy
and risk of gastrointestinal, hematologic, and cardiac
toxicities in elderly patients with stage III colon cancer. Am
J Clin Oncol 2012;35(3):228-236.
Disclosure of interest:
None declared
Keywords:
Adjuvant chemotherapy, colorectal cancer,
comorbidity, elderly