ArticleESMO open2025
Causal analyses of the impact of comorbid conditions and concomitant medications on response to neoadjuvant chemotherapy in breast cancer: analysis of a multicenter prospective cohort study (CANTO).
Article in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01993498 (A Prospective Cohort to Investigate Survivorship Issues in Patients With Early Cancer), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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A Prospective Cohort to Investigate Survivorship Issues in Patients With Early Cancer
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23 authors.
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Abstract
backgroundThe incidence of breast cancer (BC) increases with age, together with the frequency of comorbid conditions and chronic concomitant medications. However, little evidence is available regarding their impact on response to treatment in the neoadjuvant setting. MATERIALS AND
methodsThe aim of the study was to describe the comorbid conditions and concomitant medications in a population of BC patients and to assess whether the use of concomitant medications modifies the pathological complete response (pCR) rates to neoadjuvant chemotherapy (NAC) in a causal manner. Patients with invasive stage I-III BC from the French multicenter longitudinal prospective cohort CANcer TOxicities (CANTO) (NCT01993498) were included. Chronic concomitant medication intakes during NAC were binary-categorized at level 2 of the Anatomical Therapeutic Chemical (ATC) classification system. The average causal effect of concomitant medication on pCR was estimated using a doubly robust estimator (targeted maximum likelihood estimation) after adjustment on clinical and pathological factors, including notably chronic comorbid conditions.
resultsOut of 1420 patients with BC treated by NAC included in the study, 662 patients (46.6%) had at least one chronic comorbid condition and 355 patients (25.0%) declared at least one chronic concomitant medication. After causal analyses, several drug classes were significantly associated with pCR: drugs used in diabetes and lipid-modifying agents were significantly associated with increased response to NAC [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.03-3.27, P < 0.001 and OR 1.58, 95% CI 1.16-2.13, P < 0.001, respectively], while the use of cardiac therapy and diuretics was significantly associated with decreased response to NAC (OR 0.55, 95% CI 0.35-0.84, P < 0.001 and OR 0.43, 95% CI 0.21-0.85, P < 0.001, respectively).
conclusionsThe use of several classes of concomitant medication during NAC can be associated with changes in pCR rates. Further research is needed on the interactions between NAC and chronic non-anticancer drug use.
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