Myths Give Way to the New Realities of Oncology (Clinical Report‪)‬

This year has seen the presentation of two studies that will certainly have an important impact on the daily practice of oncologists worldwide. They have addressed two myths: the first concerns the lack of efficacy of adjuvant chemotherapy in elderly breast cancer patients, and the second the positive impact of bisphosphonates on breast cancer patient survival. Adjuvant chemotherapy has led to improvements in relapse-free and overall survival in patients with breast cancer, yet many older patients are not offered these potentially life-saving treatments. Moreover, older patients have been either excluded or underrepresented in most adjuvant trials, limiting the generalisability of these treatments to older populations. Limited data in the elderly suggest that they derive significant benefits from adjuvant therapies provided they have life expectancies exceeding 5 years. Making treatment decisions in the elderly is challenging as many have major comorbidities that may substantially limit life expectancy and minimise or negate the benefits of adjuvant chemotherapy [1].