Research Papers: Gerotarget (Focus on Aging):
The impact of adjuvant chemotherapy in older breast cancer patients on clinical and biological aging parameters
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Barbara Brouwers1, Sigrid Hatse1, Lissandra Dal Lago2, Patrick Neven3, Peter Vuylsteke4, Bruna Dalmasso1,5, Guy Debrock6, Heidi Van Den Bulck7, Ann Smeets3, Oliver Bechter1, Jithendra Kini Bailur8, Cindy Kenis9, Annouschka Laenen10, Patrick Schöffski1, Graham Pawelec8,11, Fabrice Journe12, Ghanem-Elias Ghanem12 and Hans Wildiers1,3
1 Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
2 Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
3 Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium
4 Department of Medical Oncology, Clinique et Maternité Sainte-Elisabeth, Namur, Belgium
5 Department of Internal Medicine, Istituto di Ricerca a Carattere Clinico e Scientifico (IRCCS), Azienda Ospedaliera Universitaria (AOU) San Martino Istituto Nazionale Tumori (IST), Genoa, Italy
6 Department of Medical Oncology, Ziekenhuizen Oost Limburg (ZOL), Genk, Belgium
7 Department of Medical Oncology, Imelda Ziekenhuis Bondheiden, Belgium
8 Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Tübingen, Germany
9 Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Belgium
10 Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Leuven, Belgium
11 School of Science and Technology, Nottingham Trent University, Nottingham, UK
12 Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
Barbara Brouwers, email:
Keywords: breast cancer, older patients, adjuvant chemotherapy, biological aging, aging biomarkers
Received: February 16, 2016 Accepted: April 08, 2016 Published: April 18, 2016
Purpose: This prospective observational study aimed to evaluate the impact of adjuvant chemotherapy on biological and clinical markers of aging and frailty.
Methods: Women ≥ 70 years old with early breast cancer were enrolled after surgery and assigned to a chemotherapy (Docetaxel and Cyclophosphamide) group (CTG, n=57) or control group (CG, n=52) depending on their planned adjuvant treatment. Full geriatric assessment (GA) and Quality of Life (QoL) were evaluated at inclusion (T0), after 3 months (T1) and at 1 year (T2). Blood samples were collected to measure leukocyte telomere length (LTL), levels of interleukin-6 (IL-6) and other circulating markers potentially informative for aging and frailty: Interleukin-10 (IL-10), Tumor Necrosis Factor Alpha (TNF-α), Insulin-like Growth Factor 1 (IGF-1), Monocyte Chemotactic Protein 1 (MCP-1) and Regulated on Activation, Normal T cell Expressed and Secreted (RANTES).
Results: LTL decreased significantly but comparably in both groups, whereas IL-6 was unchanged at T2. However, IL-10, TNF-α, IGF-1 and MCP-1 suggested a minor biological aging effect of chemotherapy. Clinical frailty and QoL decreased at T1 in the CTG, but recovered at T2, while remaining stable in the CG.
Conclusion: Chemotherapy (TC) is unlikely to amplify clinical aging or induce frailty at 1 year. Accordingly, there is no impact on the most established aging biomarkers (LTL, IL-6).
Primary Contact _
Lissandra Dal Lago
Heidi Van Den Bulck
Jithendra Kini Bailur
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