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Older Breast Cancer Survivors May Experience Accelerated Aging, Worse Functional Outcomes Following Chemotherapy


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Investigators have found that older breast cancer survivors—particularly those exposed to chemotherapy—may experience greater epigenetic aging and poorer outcomes than those without a history of cancer, according to a new study published by Rentscher et al in Cancer.

Background

Epigenetic aging provides a method for measuring the underlying aging process and may be a useful clinical tool in identifying cancer survivors at greater risk for poorer outcomes and quality of life.

“Differences in underlying biological age and ability to withstand the rigors of cancer therapy are not always clinically obvious and can vary widely even at the same chronological age, suggesting that measures like epigenetic [aging] might provide a useful component of care and geriatric assessments,” explained co–senior study author Jeanne Mandelblatt, MD, MPH, Professor of Oncology at the School of Medicine as well as Founder and Director of the Lombardi Institute for Cancer and Aging Research at Georgetown University.  

Study Methods and Results

In the new study, the investigators used data from the Thinking and Living with Cancer (ClinicalTrials.gov identifier: NCT03451383) cohort to compare the biological aging of breast cancer survivors with controls at two timepoints between 24 and 60 months after enrollment in order to examine whether cancer and its treatments could accelerate aging. The investigators reported that the patients who participated in the study were aged 62 to 84 years—most of whom had early-stage breast cancer and 32.6% of whom had received chemotherapy.         

At 24 months, the investigators discovered that the breast cancer survivors were biologically older than controls and that these differences persisted as long as 60 months. Additionally, breast cancer survivors who received chemotherapy showed the largest differences. For instance, female patients with an older epigenetic age reported worse cognitive function.

Conclusions

“Our results indicate that cancer treatment exposure, and in particular chemotherapy, is associated with more aging at the biological level, providing support to the concept that some cancer treatments may accelerate aging,” emphasized co–senior study author Judith Carroll, PhD, Associate Adjunct Professor of Psychiatry and Behavioral Sciences at the David Geffen School of Medicine and Director of the Aging Biology and Behavior Laboratory at the Norman Cousins Center for Psychoneuroimmunology at the University of California, Los Angeles (UCLA).

“These findings can help inform future research that examines whether biological aging markers may be useful clinical tools to identify cancer survivors at increased risk for worse outcomes and to intervene to prevent or slow functional declines and improve [quality of life] following cancer treatment,” concluded lead study author Kelly Rentscher, PhD, Assistant Professor of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin.

Disclosure: The research in this study was funded by grants from the National Institutes of Health and the UCLA Cousins Center for Psychoneuroimmunology. For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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