@article{ca7ded3fc93f47389b5439cf67c3554c,
title = "Functional Decline and Resilience in Older Women Receiving Adjuvant Chemotherapy for Breast Cancer",
abstract = "Objectives: To analyze self-reported changes in physical function in older women with breast cancer receiving adjuvant chemotherapy. Design: Secondary analysis of the Cancer and Leukemia Group B (CALGB) 49907 prospective randomized clinical trial. Setting: CALGB institutions in the United States. Participants: Women aged 65 and older with Stage I to III breast cancer enrolled in CALGB 49907 who had physical function data from before and after receipt of adjuvant chemotherapy (N=256; mean age 71.5, range 65–85). Measurements: Participants were administered the physical function subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire before chemotherapy, at the end of chemotherapy, and 12 months after chemotherapy initiation. Functional decline was defined as a more than 10-point decrease from baseline at each time point. Resilience was defined as return to within 10 points of baseline. Multivariable regression was used to examine pretreatment characteristics associated with physical function changes. Results: Of 42% of participants who had physical function decline from before to the end of chemotherapy, 47% recovered by 12 months (were resilient). Almost one-third experienced functional decline from before chemotherapy to 12 months later. Pretreatment fatigue was a risk factor for functional decline from before to the end of chemotherapy (P=.02). Risk factors for functional decline at 12 months included pretreatment dyspnea (P=.007) and being unmarried (P=.01). Conclusion: Functional decline was common in older women receiving adjuvant chemotherapy for breast cancer in a clinical trial. Although half recovered their physical function, one-third had a clinically meaningful decline at 12 months. Strategies are needed to prevent functional decline in older adults receiving chemotherapy. J Am Geriatr Soc 67:920–927, 2019.",
keywords = "breast neoplasms, older adults, quality of life, resilience",
author = "Arti Hurria and Enrique Soto-Perez-de-Celis and Allred, {Jacob B.} and Cohen, {Harvey Jay} and Anait Arsenyan and Karla Ballman and Jennifer Le-Rademacher and Aminah Jatoi and Julie Filo and Jeanne Mandelblatt and Lafky, {Jacqueline M.} and Gretchen Kimmick and Klepin, {Heidi D.} and Freedman, {Rachel A.} and Harold Burstein and Julie Gralow and Wolff, {Antonio C.} and Gustav Magrinat and Myra Barginear and Hyman Muss",
note = "Funding Information: From the *City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, California; †Instituto Nacional de Ciencias M{\'e}dicas y Nutrici{\'o}n Salvador Zubir{\'a}n, Mexico City, Mexico; ‡Mayo Clinic, Rochester, Minnesota; §Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina; ¶Weill Medical College, Cornell University, New York, New York; kDepartment of Health Sciences Research, Mayo Clinic, Rochester, Minnesota; **MedStar Georgetown University Hospital, Washington, District of Columbia; ††Wake Forest University Health Sciences, Winston Salem, North Carolina; ‡‡Dana-Farber Cancer Institute, Boston, Massachusetts; §§University of Washington Seattle Cancer Care Alliance, Seattle, Washington; ¶¶Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland;kkCone Health Cancer Center, Greensboro, North Carolina; ***Northwell Health-North Shore Long Island Jewish Medical Center, New Hyde Park, New York; and †††the University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina. Funding Information: ClinicalTrials.gov Identifier: NCT00024102 (49907) Financial Disclosure: Research reported in this publication was supported by the National Cancer Institute (NCI), National Institutes of Health under Award UG1CA189823 (Alliance for Clinical Trials in Oncology NCORP Grant), U10CA003927, U10CA007968, U10CA032291, U10CA033601, U10CA047559, U10CA047577, U10CA077406, U10CA077597, U10CA077651, U10CA180790, CA180802, CA180820, CA180863, U10CA180867, U10CA180857, U10CA180838, U10CA180888, 2U10CA077202, and P30-AG-028716 from the National Institute on Aging to the Duke Claude Pepper Older Americans Independence Center, U10CA85850. This research was supported in part by NCI grants U10CA084131, K05CA096940, R01CA129769, R01CA127617, and R35CA197289 to JSM. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of Interest: Arti Hurria reports research funding from Celgene, Novartis, and GlaxoSmithKlein and has served as a consultant for Boehringer Ingelheim Pharmaceuticals, Carevive, Sanofi, GTx, Inc., Pierian Biosciences, and MJH Healthcare Holdings, LLC outside the submitted work. Karla Ballman reports research funding from the NCI. Gretchen Kimmick reports research funding from Roche, Genentech, Abraxis BioScience, Bristol-Meyers Squibb, Puma Biotechnology, Wyeth, Novartis, GlaxoSmithKlein, Johnson & Johnson and Travel accommodations and expenses from Genomic Health. Rachel A. Freedman reports research funding from Puma Biotechnology, Genentech, and Eisai. Julie Gralow reports consulting for Novartis, Genentech, Bayer, Pfizer, Merck, Puma Biotechnology, and AstraZeneca. Antonio Wolff reports research funding from Myriad Genetics, and Pfizer and patents, royalties, and other intellectual property; he has been named as an inventor on one or more issued patents or pending patent applications relating to methylation in breast cancer, has assigned his rights to JHU, and participates in a royalty sharing agreement with JHU. Author Contributions: Conception and design: AH, HM. Collection and assembly of data: JBA, KB, HM. Data analysis and interpretation: ES, JBA, HJC, AA, KB, JLR, AJ, JF, JM, JML, GK, HDK, RAF, HB, JG, ACW, GM, MB, HM. Sponsor's Role: None. Funding Information: ClinicalTrials.gov Identifier: NCT00024102 (49907) Financial Disclosure: Research reported in this publication was supported by the National Cancer Institute (NCI), National Institutes of Health under Award UG1CA189823 (Alliance for Clinical Trials in Oncology NCORP Grant), U10CA003927, U10CA007968, U10CA032291, U10CA03 3601, U10CA047559, U10CA047577, U10CA077406, U10 CA077597, U10CA077651, U10CA180790, CA180802, CA180820, CA180863, U10CA180867, U10CA180857, U10CA180838, U10CA180888, 2U10CA077202, and P30-AG-028716 from the National Institute on Aging to the Duke Claude Pepper Older Americans Independence Center, U10CA85850. This research was supported in part by NCI grants U10CA084131, K05CA096940, R01CA129769, R01CA127617, and R35CA197289 to JSM. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2018, Copyright the Authors Journal compilation {\textcopyright} 2018, The American Geriatrics Society",
year = "2019",
month = may,
doi = "10.1111/jgs.15493",
language = "English (US)",
volume = "67",
pages = "920--927",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "5",
}