Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study

Mina S. Sedrak; Can Lan Sun; Marie Bae; Rachel A. Freedman; Allison Magnuson; Tracey O’Connor; Beverly Moy; Tanya M. Wildes; Heidi D. Klepin; Andrew E. Chapman; William P. Tew; Efrat Dotan; Mary Anne Fenton; Heeyoung Kim; Vani Katheria; Hyman B. Muss; Harvey J. Cohen; Cary P. Gross; Jingran Ji

doi:10.1007/s11764-024-01594-3

Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study

Mina S. Sedrak, Can Lan Sun, Marie Bae, Rachel A. Freedman, Allison Magnuson, Tracey O’Connor, Beverly Moy, Tanya M. Wildes, Heidi D. Klepin, Andrew E. Chapman, William P. Tew, Efrat Dotan, Mary Anne Fenton, Heeyoung Kim, Vani Katheria, Hyman B. Muss, Harvey J. Cohen, Cary P. Gross, Jingran Ji

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

PURPOSE: This study aimed to assess whether physical functional decline in older women with early-stage breast cancer is driven by cancer, chemotherapy, or a combination of both.

METHODS: We prospectively sampled three groups of women aged ≥ 65: 444 with early-stage breast cancer receiving chemotherapy (BC Chemo), 98 with early-stage breast cancer not receiving chemotherapy (BC Control), and 100 non-cancer controls (NC Control). Physical function was assessed at two timepoints (T1 [baseline] and T2 [3, 4, or 6 months]) using the Physical Functioning Subscale (PF-10) of the RAND 36-item Short Form. The primary endpoint was the change in PF-10 scores from T1 to T2, analyzed continuously and dichotomously (Yes/No, with "yes" indicating a PF-10 decline > 10 points, i.e., a substantial and clinically meaningful difference).

RESULTS: Baseline PF-10 scores were similar across all groups. The BC Chemo group experienced a significant decline at T2, with a median change in PF-10 of -5 (interquartile range [IQR], -20, 0), while BC Control and NC Control groups showed a median change of 0 (IQR, -5, 5; p < 0.001). Over 30% of BC Chemo participants had a substantial decline in PF-10 vs. 8% in the BC Control and 5% in the NC Control groups (p < 0.001).

CONCLUSION: In this cohort of older adults with early-stage breast cancer, the combination of breast cancer and chemotherapy contributes to accelerated functional decline. Our findings reinforce the need to develop interventions aimed at preserving physical function, particularly during and after chemotherapy.

IMPLICATIONS FOR CANCER SURVIVORS: The high prevalence of accelerated functional decline in older women undergoing breast cancer chemotherapy underscores the urgency to develop interventions aimed at preserving physical function and improving health outcomes.

CLINICAL TRIAL: NCT01472094, Hurria Older PatiEnts (HOPE) with Breast Cancer Study.

Original language	English
Pages (from-to)	1131-1143
Number of pages	13
Journal	Journal of Cancer Survivorship
Volume	18
Issue number	4
Early online date	Mar 28 2024
DOIs	https://doi.org/10.1007/s11764-024-01594-3
State	Published - Jul 2024

Keywords

Adjuvant Chemotherapy
Breast cancer
Older adults
Physical function
Cancer Survivors
Prospective Studies
Humans
Case-Control Studies
Aged, 80 and over
Quality of Life
Female
Aged
Breast Neoplasms/drug therapy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s11764-024-01594-3

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Sedrak, M. S., Sun, C. L., Bae, M., Freedman, R. A., Magnuson, A., O’Connor, T., Moy, B., Wildes, T. M., Klepin, H. D., Chapman, A. E., Tew, W. P., Dotan, E., Fenton, M. A., Kim, H., Katheria, V., Muss, H. B., Cohen, H. J., Gross, C. P., & Ji, J. (2024). Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study. Journal of Cancer Survivorship, 18(4), 1131-1143. https://doi.org/10.1007/s11764-024-01594-3

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title = "Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study",

abstract = "PURPOSE: This study aimed to assess whether physical functional decline in older women with early-stage breast cancer is driven by cancer, chemotherapy, or a combination of both.METHODS: We prospectively sampled three groups of women aged ≥ 65: 444 with early-stage breast cancer receiving chemotherapy (BC Chemo), 98 with early-stage breast cancer not receiving chemotherapy (BC Control), and 100 non-cancer controls (NC Control). Physical function was assessed at two timepoints (T1 [baseline] and T2 [3, 4, or 6 months]) using the Physical Functioning Subscale (PF-10) of the RAND 36-item Short Form. The primary endpoint was the change in PF-10 scores from T1 to T2, analyzed continuously and dichotomously (Yes/No, with {"}yes{"} indicating a PF-10 decline > 10 points, i.e., a substantial and clinically meaningful difference).RESULTS: Baseline PF-10 scores were similar across all groups. The BC Chemo group experienced a significant decline at T2, with a median change in PF-10 of -5 (interquartile range [IQR], -20, 0), while BC Control and NC Control groups showed a median change of 0 (IQR, -5, 5; p < 0.001). Over 30% of BC Chemo participants had a substantial decline in PF-10 vs. 8% in the BC Control and 5% in the NC Control groups (p < 0.001).CONCLUSION: In this cohort of older adults with early-stage breast cancer, the combination of breast cancer and chemotherapy contributes to accelerated functional decline. Our findings reinforce the need to develop interventions aimed at preserving physical function, particularly during and after chemotherapy.IMPLICATIONS FOR CANCER SURVIVORS: The high prevalence of accelerated functional decline in older women undergoing breast cancer chemotherapy underscores the urgency to develop interventions aimed at preserving physical function and improving health outcomes.CLINICAL TRIAL: NCT01472094, Hurria Older PatiEnts (HOPE) with Breast Cancer Study.",

keywords = "Adjuvant Chemotherapy, Breast cancer, Older adults, Physical function, Cancer Survivors, Prospective Studies, Humans, Case-Control Studies, Aged, 80 and over, Quality of Life, Female, Aged, Breast Neoplasms/drug therapy",

author = "Sedrak, {Mina S.} and Sun, {Can Lan} and Marie Bae and Freedman, {Rachel A.} and Allison Magnuson and Tracey O{\textquoteright}Connor and Beverly Moy and Wildes, {Tanya M.} and Klepin, {Heidi D.} and Chapman, {Andrew E.} and Tew, {William P.} and Efrat Dotan and Fenton, {Mary Anne} and Heeyoung Kim and Vani Katheria and Muss, {Hyman B.} and Cohen, {Harvey J.} and Gross, {Cary P.} and Jingran Ji",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.",

year = "2024",

month = jul,

doi = "10.1007/s11764-024-01594-3",

language = "English",

volume = "18",

pages = "1131--1143",

journal = "Journal of Cancer Survivorship",

issn = "1932-2259",

publisher = "Springer New York",

number = "4",

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Sedrak, MS, Sun, CL, Bae, M, Freedman, RA, Magnuson, A, O’Connor, T, Moy, B, Wildes, TM, Klepin, HD, Chapman, AE, Tew, WP, Dotan, E, Fenton, MA, Kim, H, Katheria, V, Muss, HB, Cohen, HJ, Gross, CP & Ji, J 2024, 'Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study', Journal of Cancer Survivorship, vol. 18, no. 4, pp. 1131-1143. https://doi.org/10.1007/s11764-024-01594-3

Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study. / Sedrak, Mina S.; Sun, Can Lan; Bae, Marie et al.
In: Journal of Cancer Survivorship, Vol. 18, No. 4, 07.2024, p. 1131-1143.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls

T2 - results from the Hurria Older PatiEnts (HOPE) prospective study

AU - Sedrak, Mina S.

AU - Sun, Can Lan

AU - Bae, Marie

AU - Freedman, Rachel A.

AU - Magnuson, Allison

AU - O’Connor, Tracey

AU - Moy, Beverly

AU - Wildes, Tanya M.

AU - Klepin, Heidi D.

AU - Chapman, Andrew E.

AU - Tew, William P.

AU - Dotan, Efrat

AU - Fenton, Mary Anne

AU - Kim, Heeyoung

AU - Katheria, Vani

AU - Muss, Hyman B.

AU - Cohen, Harvey J.

AU - Gross, Cary P.

AU - Ji, Jingran

N1 - Publisher Copyright: © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

PY - 2024/7

Y1 - 2024/7

N2 - PURPOSE: This study aimed to assess whether physical functional decline in older women with early-stage breast cancer is driven by cancer, chemotherapy, or a combination of both.METHODS: We prospectively sampled three groups of women aged ≥ 65: 444 with early-stage breast cancer receiving chemotherapy (BC Chemo), 98 with early-stage breast cancer not receiving chemotherapy (BC Control), and 100 non-cancer controls (NC Control). Physical function was assessed at two timepoints (T1 [baseline] and T2 [3, 4, or 6 months]) using the Physical Functioning Subscale (PF-10) of the RAND 36-item Short Form. The primary endpoint was the change in PF-10 scores from T1 to T2, analyzed continuously and dichotomously (Yes/No, with "yes" indicating a PF-10 decline > 10 points, i.e., a substantial and clinically meaningful difference).RESULTS: Baseline PF-10 scores were similar across all groups. The BC Chemo group experienced a significant decline at T2, with a median change in PF-10 of -5 (interquartile range [IQR], -20, 0), while BC Control and NC Control groups showed a median change of 0 (IQR, -5, 5; p < 0.001). Over 30% of BC Chemo participants had a substantial decline in PF-10 vs. 8% in the BC Control and 5% in the NC Control groups (p < 0.001).CONCLUSION: In this cohort of older adults with early-stage breast cancer, the combination of breast cancer and chemotherapy contributes to accelerated functional decline. Our findings reinforce the need to develop interventions aimed at preserving physical function, particularly during and after chemotherapy.IMPLICATIONS FOR CANCER SURVIVORS: The high prevalence of accelerated functional decline in older women undergoing breast cancer chemotherapy underscores the urgency to develop interventions aimed at preserving physical function and improving health outcomes.CLINICAL TRIAL: NCT01472094, Hurria Older PatiEnts (HOPE) with Breast Cancer Study.

AB - PURPOSE: This study aimed to assess whether physical functional decline in older women with early-stage breast cancer is driven by cancer, chemotherapy, or a combination of both.METHODS: We prospectively sampled three groups of women aged ≥ 65: 444 with early-stage breast cancer receiving chemotherapy (BC Chemo), 98 with early-stage breast cancer not receiving chemotherapy (BC Control), and 100 non-cancer controls (NC Control). Physical function was assessed at two timepoints (T1 [baseline] and T2 [3, 4, or 6 months]) using the Physical Functioning Subscale (PF-10) of the RAND 36-item Short Form. The primary endpoint was the change in PF-10 scores from T1 to T2, analyzed continuously and dichotomously (Yes/No, with "yes" indicating a PF-10 decline > 10 points, i.e., a substantial and clinically meaningful difference).RESULTS: Baseline PF-10 scores were similar across all groups. The BC Chemo group experienced a significant decline at T2, with a median change in PF-10 of -5 (interquartile range [IQR], -20, 0), while BC Control and NC Control groups showed a median change of 0 (IQR, -5, 5; p < 0.001). Over 30% of BC Chemo participants had a substantial decline in PF-10 vs. 8% in the BC Control and 5% in the NC Control groups (p < 0.001).CONCLUSION: In this cohort of older adults with early-stage breast cancer, the combination of breast cancer and chemotherapy contributes to accelerated functional decline. Our findings reinforce the need to develop interventions aimed at preserving physical function, particularly during and after chemotherapy.IMPLICATIONS FOR CANCER SURVIVORS: The high prevalence of accelerated functional decline in older women undergoing breast cancer chemotherapy underscores the urgency to develop interventions aimed at preserving physical function and improving health outcomes.CLINICAL TRIAL: NCT01472094, Hurria Older PatiEnts (HOPE) with Breast Cancer Study.

KW - Adjuvant Chemotherapy

KW - Breast cancer

KW - Older adults

KW - Physical function

KW - Cancer Survivors

KW - Prospective Studies

KW - Humans

KW - Case-Control Studies

KW - Aged, 80 and over

KW - Quality of Life

KW - Female

KW - Aged

KW - Breast Neoplasms/drug therapy

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U2 - 10.1007/s11764-024-01594-3

DO - 10.1007/s11764-024-01594-3

M3 - Article

C2 - 38678525

AN - SCOPUS:85191743801

SN - 1932-2259

VL - 18

SP - 1131

EP - 1143

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

IS - 4

ER -

Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study

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Keywords

UN SDGs

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