Most Read Articles
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course
Christina Lau, 22 Oct 2015
A 21-gene expression assay can identify patients with early-stage breast cancer who can skip adjuvant chemotherapy without facing an increased risk of recurrence at 5 years.
Cathy Chow, PhD, 27 Aug 2015

HER2-positive breast cancer tends to be more aggressive, has worse patient prognosis, and responds less to treatment. A two-pronged approach to block the HER pathway via pertuzumab (Perjeta®, Roche), a first-in-class HER dimerization inhibitor, in combination with trastuzumab and chemotherapy, may offer more treatment options for HER2-positive metastatic breast cancer patients as well as those with early breast cancer. 

Saras Ramiya, 25 Oct 2017
The first patient-reported outcomes study on durvalumab treatment after chemoradiation in locally advanced non-small cell lung cancer (NSCLC) shows patients’ quality of life is similar to that of the patients who received placebo.

Reasons why clinicians do not recommend adjuvant chemotherapy

19 Mar 2017

A recent study shows that discussion at a multidisciplinary meeting enables the identification of cancer patients unsuitable for adjuvant therapy.

Researchers argue that the reasons for refusing chemotherapy should be fully examined to make sure that treatment preferences of patients are balanced against the proven benefits of chemotherapy.

To determine reasons why clinicians do not recommend adjuvant chemotherapy and why patients decline recommended chemotherapy, a retrospective, single institution Australian study was conducted on all surgically managed stage III colon cancer patients diagnosed at the regional cancer centre at Toowoomba Hospital between July 2010 and December 2014.

Of the 109 patients suitable for evaluation, 72 (66.1 percent) received adjuvant chemotherapy. Clinicians did not recommend chemotherapy in 25 (23.4 percent) patients, with the majority (68 percent) having more than one cited reason.

The most common reasons for not recommending chemotherapy were multiple comorbidities and advanced age (p<0.01). Age alone was not a reason for nonrecommendation.

There were 12 (11 percent) patients who refused chemotherapy despite recommendation. Majority of patient charts (63.6 percent) did not elaborate the reasons for refusal. Travel distance did not count as a factor in accepting or declining chemotherapy.

“Attendance at a regional cancer centre provides the opportunity for high standard care in the management of stage III colon cancer,” researchers suggested.

These findings were similar to a 2012 study on surgically treated stage III colon cancer patients, which found that the most frequent reason for not recommending adjuvant chemotherapy was the presence of one or more comorbidities, or combination of comorbidity and age or frailty. [BMC Res Notes 2012;5:269]

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Most Read Articles
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course
Christina Lau, 22 Oct 2015
A 21-gene expression assay can identify patients with early-stage breast cancer who can skip adjuvant chemotherapy without facing an increased risk of recurrence at 5 years.
Cathy Chow, PhD, 27 Aug 2015

HER2-positive breast cancer tends to be more aggressive, has worse patient prognosis, and responds less to treatment. A two-pronged approach to block the HER pathway via pertuzumab (Perjeta®, Roche), a first-in-class HER dimerization inhibitor, in combination with trastuzumab and chemotherapy, may offer more treatment options for HER2-positive metastatic breast cancer patients as well as those with early breast cancer. 

Saras Ramiya, 25 Oct 2017
The first patient-reported outcomes study on durvalumab treatment after chemoradiation in locally advanced non-small cell lung cancer (NSCLC) shows patients’ quality of life is similar to that of the patients who received placebo.