Data Show Older Lymphoma and Breast Cancer Patients are Under-Treated.

2001 JAN 11 - (NewsRx.com) -- According to data presented at the American Society of Hematology (ASH) meeting and the San Antonio Breast Cancer Symposium held in December 2000, elderly cancer patients may be up to two times as likely as younger patients to receive chemotherapy doses below the levels demonstrated in previously-published studies to provide the best chances for survival.

Authors from both studies, which were funded by pharmaceutical company Amgen, suggest that sub-optimal chemotherapy dosing may help explain poorer response and survival outcomes m the elderly, and that neutropenia (low white blood cell count) is a major contributor to reduced chemotherapy doses in the elderly.

The first set of data, presented December 2, 2000, at ASH, looked at the medical records of 1,761 patients with intermediate-grade non-Hodgkin's lymphoma (an aggressive type of non-Hodgkin's lymphoma that grows quickly and causes severe symptoms), to analyze the relationship between age, side effects, and chemotherapy dose reductions.

The second data analysis, presented December 7, 2000, at the San Antonio Breast Cancer Symposium, reviewed the medical charts of 20,799 breast cancer patients who received adjuvant chemotherapy to investigate physicians' practice patterns and factors that contribute to chemotherapy dose variations.

"When elderly cancer patients receive full chemotherapy doses, their survival rates are as good as younger patients. These data suggest that doctors are not dosing older patients as optimally as they are younger patients," said Gary Lyman, MT), MPH, Albany Medical Center. "If we aggressively address the factors, such as neutropenia, that are causing elderly patients to receive sub-optimal chemotherapy, we may have a positive impact on their long-term survival."

Researchers in the Lymphoma Service of Memorial Sloan Kettering Cancer Center looked at the medical records of 1,761 intermediate-grade NHL patients (49% were older than 65 years in age) from 226 community oncology practices across the United States to determine the relationship between age, various clinical parameters, and chemotherapy regimen modifications. In the study, 1,514 patients (86%) had received CHOP, the standard treatment; 141 patients (8%) had received CNOP; and 106 patients (6%) had received CVP.

The data reviewed demonstrated that older patients were more frequently prescribed less aggressive chemotherapy regimens (CNOP and CVP) than CHOP (21% versus 7%, p[less than].001). Also, regardless of regimen, older patients were 1.8 times more likely to be started at a lower dose intensity, and two times more likely to receive dose reductions or delays than younger patients. Overall, 43% of elderly patients and 23% of younger patients received sub-optimal dosing.