دورية أكاديمية
أعرض في EDS

Time to Cancer Treatment and Chemotherapy Relative Dose Intensity for Patients With Breast Cancer Living With HIV.

التفاصيل البيبلوغرافية
العنوان: Time to Cancer Treatment and Chemotherapy Relative Dose Intensity for Patients With Breast Cancer Living With HIV.
المؤلفون: O'Neil DS; Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.; Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut., Martei YM; Department of Medicine (Hematology-Oncology), University of Pennsylvania, Philadelphia.; Abramson Cancer Center, Perelman School of Medicine, Philadelphia, Pennsylvania., Crew KD; Division of Hematology/Oncology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York, New York.; Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York., Castillo BS; Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia., Costa P; Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut., Lim T; Perelman School of Medicine, University of Pennsylvania, Philadelphia., Michel A; Division of Hematology/Oncology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York, New York., Rubin E; Memorial Cancer Institute, Memorial Healthcare System, Hollywood, Florida., Goel N; Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.; Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida., Hurley J; Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida.; Division of Medical Oncology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida., Lopes G; Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida.; Division of Medical Oncology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida., Antoni MH; Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida.; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.
المصدر: JAMA network open [JAMA Netw Open] 2023 Dec 01; Vol. 6 (12), pp. e2346223. Date of Electronic Publication: 2023 Dec 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Breast Neoplasms*/complications , Breast Neoplasms*/drug therapy , HIV Infections*/complications , HIV Infections*/drug therapy , HIV Infections*/epidemiology , Neutropenia*/chemically induced , Neutropenia*/epidemiology, Humans ; Female ; Middle Aged ; Retrospective Studies ; Cohort Studies ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
مستخلص: Importance: Patients with breast cancer and comorbid HIV experience higher mortality than other patients with breast cancer.
Objective: To compare time to cancer treatment initiation and relative dose intensity (RDI) of neoadjuvant and adjuvant chemotherapy among patients with breast cancer with vs without HIV.
Design, Setting, and Participants: A retrospective, matched cohort study enrolled women who received a diagnosis of breast cancer from January 1, 2000, through December 31, 2018. The electronic medical records of 3 urban, academic cancer centers were searched for women with confirmed HIV infection prior to or simultaneous with diagnosis of stage I to III breast cancer. Tumor registry data were used to identify 2 control patients with breast cancer without HIV for each participant with HIV, matching for study site, stage, and year of cancer diagnosis. Statistical analysis was performed from December 2022 to October 2023.
Exposure: HIV infection detected before or within 90 days of participants' breast cancer diagnosis.
Main Outcomes and Measures: The primary outcome was time to breast cancer treatment initiation, defined as the number of days between cancer diagnosis and first treatment. The secondary outcome was overall RDI for patients who received chemotherapy. These outcomes were compared by HIV status using Cox proportional hazards regression and linear regression modeling, respectively, adjusting for confounding demographic and clinical factors. Exploratory outcomes included instances of anemia, neutropenia, thrombocytopenia, and liver function test result abnormalities during chemotherapy, which were compared using Fisher exact tests.
Results: The study enrolled 66 women with comorbid breast cancer and HIV (median age, 51.1 years [IQR, 45.7-58.2 years]) and 132 with breast cancer alone (median age, 53.9 years [IQR, 47.0-62.5 years]). The median time to first cancer treatment was not significantly higher among patients with HIV than those without (48.5 days [IQR, 32.0-67.0 days] vs 42.5 days [IQR, 25.0-59.0 days]; adjusted hazard ratio, 0.78, 95% CI, 0.55-1.12). Among the 36 women with HIV and 62 women without HIV who received chemotherapy, the median overall RDI was lower for those with HIV vs without HIV (0.87 [IQR, 0.74-0.97] vs 0.96 [IQR, 0.88-1.00]; adjusted P = .01). Grade 3 or higher neutropenia during chemotherapy occurred among more women with HIV than those without HIV (13 of 36 [36.1%] vs 5 of 58 [8.6%]).
Conclusions and Relevance: This matched cohort study suggests that patients with breast cancer and HIV may have experienced reduced adjuvant chemotherapy RDI, reflecting greater dose reductions, delays, or discontinuation. Strategies for supporting this vulnerable population during chemotherapy treatment are necessary.
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معلومات مُعتمدة: K01 TW011481 United States TW FIC NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS
تواريخ الأحداث: Date Created: 20231205 Date Completed: 20231207 Latest Revision: 20240628
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10698616
DOI: 10.1001/jamanetworkopen.2023.46223
PMID: 38051529
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2023.46223