Breast Cancer Chemotherapy Impacted by Diabetes Control

Diabetes appears to have an adverse effect on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer, … Full Story

Dr. Sharon H. Giordano stated that,  “We found that diabetic patients with breast cancer have higher rates of chemotherapy-related toxicities. Clinicians must be aware that diabetic patients are more likely to experience toxicity and should monitor diabetic patients closely.”

Dr. Giordano of The University of Texas M. D. Anderson Cancer Center and colleagues report in a March 23 online publication from the Journal of Clinical Oncology, that they used a Medicare database to identify more than 71,000 patients aged 66 years or more with breast cancer stages I through III.

Almost 12,000 received chemotherapy and 21% of these patients were diabetic. Those with diabetes were less likely to receive anthracyclines or taxanes and were more likely to be hospitalized because of chemotherapy-related toxicity, infection, fever, neutropenia and anemia.

The diabetic patients were also more likely to be hospitalized for any cause (odds ratio, 1.32) and had higher all-cause mortality (hazard ratio, 1.35) than nondiabetic women.

In patients who did not receive chemotherapy, breast cancer-related mortality was similar in diabetics and nondiabetics. However, in the chemotherapy cohort, it was greater in diabetics (odds ratio, 1.20).

“Despite these findings,” the researchers conclude, “patients with diabetes should continue to be offered standard chemotherapy regimens, because this study cannot definitely answer which chemotherapy offers the best risk-benefit ratio for patients with diabetes.”

J Clin Oncol 2009;27.