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Abstract
YI6 MS outcomes in breast cancer survivors and the influence of chemotherapy
BMJ neurology open, Vol.7(Suppl 1), pp.A3-A3
2025
Abstract
Background
Managing multiple sclerosis (MS) in cancer survivors is complex due to immune system interactions and the impact of treatment. Limited guidance exists on disease-modifying therapy (DMT) use during and after chemotherapy. This study examined how DMT decisions in breast cancer influence MS outcomes and whether chemotherapy itself affects MS disease activity.
Methods
Data were obtained from the MSBase registry, including 172 individuals with MS and breast cancer who received chemotherapy, and 229 for whom chemotherapy data were not available. Survival analyses assessed time to first relapse and confirmed disability progression (CDP) after cancer diagnosis, with DMT modelled as a time-varying covariate. Propensity score matching compared outcomes between those who received cancer chemotherapy adjuvant to their MS treatment and matched controls receiving standard MS treatment alone.
Results
Post-chemotherapy MS management varied, with most clinicians de-escalating or withholding DMTs. Older age was associated with lower relapse risk (HR = 0.90, 95% CI: 0.93–0.97, p = 0.001). Chemotherapy had a protective effect on time to first relapse (HR 0.58, 95% robust CI: 0.37 to 0.95, p = 0.03) compared to matched controls receiving standard MS treatment. Chemotherapy was not associated with a significant effect on CDP (HR 0.68, 95% robust CI: 0.38–1.23, p=0.06).
Conclusion
Chemotherapy was associated with better relapse outcomes compared to standard therapy in matched controls, supporting withholding or de-escalating DMTs during cancer treatment. DMT reinitiation should be guided by individual risk assessment and may be less indicated in older individuals, who demonstrated a lower relapse risk following chemotherapy.
Details
- Title
- YI6 MS outcomes in breast cancer survivors and the influence of chemotherapy
- Authors/Creators
- Nesbitt CassiePaul Sanfilippo - Monash UniversityChao Zhu - Monash UniversityOzakbas SerkanPrat AlexandreMarc Girard - Université de MontréalPierre Duquette - Université de MontréalKalincik TomasRoos IzanneKatherine Buzzard - Box Hill HospitalSkibina OlgaFoschi MatteoSurcinelli AndreaBoz CavitJeannette Lechner-Scott - John Hunter HospitalLibertinova JanaFrancesco Patti - Ospedale G.F. IngrassiaAllan Kermode - Perron Institute for Neurological and Translational SciencePedrini MarzenaWilliam Carroll - Perron Institute for Neurological and Translational ScienceMichael Barnett - Mind AustraliaBruce Taylor - Royal Brisbane and Women's HospitalSuzanne Hodgkinson - Royal Brisbane and Women's HospitalPamela Mccombe - Royal Brisbane and Women's HospitalStephen Reddel - Concord Repatriation General HospitalSteve Vucic - Concord Repatriation General HospitalRamanathan SudarshiniRichard Macdonell - The University of SydneyJohn NevinMark Slee - Monash UniversityWalt Van derButzkueven HelmutJokubaitis Vilija
- Publication Details
- BMJ neurology open, Vol.7(Suppl 1), pp.A3-A3
- Publisher
- BMJ Publishing Group LTD
- Identifiers
- 991005828907407891
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Abstract
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