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. 2024 Apr;204(3):607-615.
doi: 10.1007/s10549-023-07207-4. Epub 2024 Jan 19.

Clinical impact of delaying initiation of adjuvant chemotherapy in patients with early triple negative breast cancer

Maria Eleni Hatzipanagiotou  1 , Miriam Pigerl  2 , Michael Gerken  3 , Sophie Räpple  2 , Verena Zeltner  2 , Madeleine Hetterich  2 , Peter Ugocsai  2 , Elisabeth Christine Inwald  2 , Monika Klinkhammer-Schalke  4 , Olaf Ortmann  2 , Stephan Seitz  2
Affiliations

Clinical impact of delaying initiation of adjuvant chemotherapy in patients with early triple negative breast cancer

Maria Eleni Hatzipanagiotou et al. Breast Cancer Res Treat. 2024 Apr.

Abstract

Purpose: The optimal time to initiation of adjuvant chemotherapy (TTAC) for triple negative breast cancer (TNBC) patients is unclear. This study evaluates the association between TTAC and survival in TNBC patients.

Methods: We conducted a retrospective study using data from a cohort of TNBC patients diagnosed between January 1, 2010 to December 31, 2018, registered in the Tumor Centre Regensburg was conducted. Data included demographics, pathology, treatment, recurrence and survival. TTAC was defined as days from primary surgery to first dose of adjuvant chemotherapy. The Kaplan-Meier method was used to evaluate impact of TTAC on overall survival (OS) and 5-year OS.

Results: A total of 245 TNBC patients treated with adjuvant chemotherapy and valid TTAC data were included. Median TTAC was 29 days. The group receiving systemic therapy within 22 to 28 days after surgery had the most favorable outcome, with median OS of 10.2 years. Groups receiving systemic therapy between 29-35 days, 36-42 days, and more than 6 weeks after surgery had significantly decreased median survival, with median OS of 8.3 years, 7.8 years, and 6.9 years, respectively. Patients receiving therapy between 22-28 days had significantly better survival compared to those receiving therapy between 29-35 days (p = 0.043), and patients receiving therapy after 22-28 days also demonstrated significantly better survival compared to those receiving therapy after more than 43 days (p = 0.033).

Conclusion: Timing of adjuvant systemic therapy can influence OS in TNBC patients. Efforts should be made to avoid unnecessary delays in administering chemotherapy to ensure timely initiation of systemic therapy and optimize patient outcomes.

Keywords: Outcomes in TNBC; Population-based cancer registry; Routine practice data; Timing of adjuvant chemotherapy; Triple negative breast cancer.

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Conflict of interest statement

Miriam Pigerl, Sophie Räpple, Verena Zeltner, Peter Ugocsai, Elisabeth Inwald, Michael Gerken and Monika Klinkhammer-Schalke declare they have no financial interests. Maria Hatzipanagiotou has received Honoraria for lectures and/or consulting from Novartis, Lilly, Roche, Pfizer and AstraZeneca. Madeleine Hetterich has received speaker honoraria from Celgene, Novartis, MSD, GSK, Eisai and AstraZeneca as well as author honoraria from Thieme and Elsevier and travel reimbursement from Novartis. Olaf Ortmann is on the board of the German Cancer society. He received speaker honoraria from MSD SHARP & DOHME GMBH, Verband Forschender Arzneimittelhersteller vfa, Novo Nordisk, AstraZeneca, Aurikamed, Med Update, RG Ärztefortbildung, Pierre Fabre Pharma GmbH and holds stocks from Bayer, Novartis, Curevac and Fresenius. Stephan Seitz has received speaker honoraria from AstraZeneca, GE, GSK, IGEA, Lilly, MSD, Novartis, Pfizer, Roche and honoraria for consulting from AstraZeneca, GSK, Lilly, MSD, Novartis, Pfizer and Roche.

Figures

Fig. 1
Fig. 1
Depiction of the study collective
Fig. 2
Fig. 2
Kaplan–Meier 5 year survival rates according to TTAC
See this image and copyright information in PMC

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