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The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer
INTRODUCTION: In the South African Breast Cancer and HIV Outcomes (SABCHO) study, we previously found that breast cancer patients living with HIV and treated with neoadjuvant chemotherapy achieve lower rates of complete pathologic response than patients without HIV. We now assess the impact of comor...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546819/ https://www.ncbi.nlm.nih.gov/pubmed/36943395 http://dx.doi.org/10.1093/oncolo/oyad056 |
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author | O’Neil, Daniel S Ayeni, Oluwatosin A Farrow, Hayley A Chen, Wenlong Carl Demetriou, Georgia Buccimazza, Ines Čačala, Sharon Stopforth, Laura W Joffe, Maureen Antoni, Michael H Lopes, Gilberto Pumpalova, Yoanna S Mapanga, Witness Jacobson, Judith S Crew, Katherine D Neugut, Alfred I Ruff, Paul Cubasch, Herbert |
author_facet | O’Neil, Daniel S Ayeni, Oluwatosin A Farrow, Hayley A Chen, Wenlong Carl Demetriou, Georgia Buccimazza, Ines Čačala, Sharon Stopforth, Laura W Joffe, Maureen Antoni, Michael H Lopes, Gilberto Pumpalova, Yoanna S Mapanga, Witness Jacobson, Judith S Crew, Katherine D Neugut, Alfred I Ruff, Paul Cubasch, Herbert |
author_sort | O’Neil, Daniel S |
collection | PubMed |
description | INTRODUCTION: In the South African Breast Cancer and HIV Outcomes (SABCHO) study, we previously found that breast cancer patients living with HIV and treated with neoadjuvant chemotherapy achieve lower rates of complete pathologic response than patients without HIV. We now assess the impact of comorbid HIV on receipt of timely and complete neoadjuvant and adjuvant chemotherapy. MATERIALS AND METHODS: Since June 2015, the SABCHO study has collected data on women diagnosed with breast cancer at 6 South African hospitals. We selected a sample of participants with stages I-III cancer who received ≥2 doses of neoadjuvant or adjuvant chemotherapy. Data on chemotherapies prescribed and received, filgrastim receipt, and laboratory values measured during treatment were captured from patients’ medical records. We calculated the mean relative dose intensity (RDI) for all prescribed chemotherapies. We tested for association between full regimen RDI and HIV status, using linear regression to control for demographic and clinical covariates, and for association of HIV with laboratory abnormalities. RESULTS: The 166 participants living with HIV and 159 without HIV did not differ in median chemotherapy RDI: 0.89 (interquartile range (IQR) 0.77-0.95) among those living with HIV and 0.87 (IQR 0.77-0.94) among women without HIV. Patients living with HIV experienced more grade 3+ anemia and leukopenia than those without HIV (anemia: 10.8% vs. 1.9%, P = .001; leukopenia: 8.4% vs. 1.9%, P = .008) and were more likely to receive filgrastim (24.7% vs. 10.7%, P = .001). CONCLUSIONS: HIV status did not impact neoadjuvant or adjuvant chemotherapy RDI, although patients with breast cancer living with HIV experienced more myelotoxicity during treatment. |
format | Online Article Text |
id | pubmed-10546819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105468192023-10-04 The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer O’Neil, Daniel S Ayeni, Oluwatosin A Farrow, Hayley A Chen, Wenlong Carl Demetriou, Georgia Buccimazza, Ines Čačala, Sharon Stopforth, Laura W Joffe, Maureen Antoni, Michael H Lopes, Gilberto Pumpalova, Yoanna S Mapanga, Witness Jacobson, Judith S Crew, Katherine D Neugut, Alfred I Ruff, Paul Cubasch, Herbert Oncologist Global Health and Cancer INTRODUCTION: In the South African Breast Cancer and HIV Outcomes (SABCHO) study, we previously found that breast cancer patients living with HIV and treated with neoadjuvant chemotherapy achieve lower rates of complete pathologic response than patients without HIV. We now assess the impact of comorbid HIV on receipt of timely and complete neoadjuvant and adjuvant chemotherapy. MATERIALS AND METHODS: Since June 2015, the SABCHO study has collected data on women diagnosed with breast cancer at 6 South African hospitals. We selected a sample of participants with stages I-III cancer who received ≥2 doses of neoadjuvant or adjuvant chemotherapy. Data on chemotherapies prescribed and received, filgrastim receipt, and laboratory values measured during treatment were captured from patients’ medical records. We calculated the mean relative dose intensity (RDI) for all prescribed chemotherapies. We tested for association between full regimen RDI and HIV status, using linear regression to control for demographic and clinical covariates, and for association of HIV with laboratory abnormalities. RESULTS: The 166 participants living with HIV and 159 without HIV did not differ in median chemotherapy RDI: 0.89 (interquartile range (IQR) 0.77-0.95) among those living with HIV and 0.87 (IQR 0.77-0.94) among women without HIV. Patients living with HIV experienced more grade 3+ anemia and leukopenia than those without HIV (anemia: 10.8% vs. 1.9%, P = .001; leukopenia: 8.4% vs. 1.9%, P = .008) and were more likely to receive filgrastim (24.7% vs. 10.7%, P = .001). CONCLUSIONS: HIV status did not impact neoadjuvant or adjuvant chemotherapy RDI, although patients with breast cancer living with HIV experienced more myelotoxicity during treatment. Oxford University Press 2023-03-21 /pmc/articles/PMC10546819/ /pubmed/36943395 http://dx.doi.org/10.1093/oncolo/oyad056 Text en © The Author(s) 2023. Published by Oxford University Press. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Global Health and Cancer O’Neil, Daniel S Ayeni, Oluwatosin A Farrow, Hayley A Chen, Wenlong Carl Demetriou, Georgia Buccimazza, Ines Čačala, Sharon Stopforth, Laura W Joffe, Maureen Antoni, Michael H Lopes, Gilberto Pumpalova, Yoanna S Mapanga, Witness Jacobson, Judith S Crew, Katherine D Neugut, Alfred I Ruff, Paul Cubasch, Herbert The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title | The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title_full | The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title_fullStr | The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title_full_unstemmed | The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title_short | The Impact of HIV Infection on Neoadjuvant and Adjuvant Chemotherapy Relative Dose Intensity in South African Patients with Breast Cancer |
title_sort | impact of hiv infection on neoadjuvant and adjuvant chemotherapy relative dose intensity in south african patients with breast cancer |
topic | Global Health and Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546819/ https://www.ncbi.nlm.nih.gov/pubmed/36943395 http://dx.doi.org/10.1093/oncolo/oyad056 |
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