The results of a longitudinal cohort study published in JAMA suggest that frailty following adjuvant chemotherapy may be associated with long-term survival among older women with nonmetastatic breast cancer.
Women who experienced rapid frailty progression, or nonresilience, following their adjuvant chemotherapy had worse survival outcomes compared with those who were more stable or had transient worsening from chemotherapy induction. The 5-year mortality rate among women in the nonresilient group was 52.1% compared with 20.3% in the resilient and stable groups. Individual predictions of risk of death were not able to be determined through frailty monitoring.
Study Methodology
Duchesneau et al analyzed frailty trajectories in 20,292 women aged 65 or older with stage I to III breast cancer who were receiving adjuvant chemotherapy. The participants were identified from Surveillance, Epidemiology, and End Results (SEER) cancer registries linked to Medicare claims data. Every 30 days from chemotherapy initiation, the patients were assessed with the Faurot frailty index for factors of diagnosis, procedure, and durable medical equipment claims.
Among the eligible women, 4.5% had nonresilient trajectories, 79.4% were stable, and 16.1% had resilient trajectories. “Our research demonstrates that frailty is not a static condition but can change over time, especially during cancer treatment. By closely monitoring frailty trajectories, health-care providers can better identify patients at increased risk and implement timely interventions to improve survival outcomes,” said study author Dae Hyun Kim, MD, MPH, ScD, associate scientist and founder of the Frailty Research Program at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife.
The findings of the study highlighted a need for future research into whether or not frailty monitoring and interventions can improve outcomes in this patient population, and possibly whether monitoring can predict for falls or hospitalizations.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
