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https://www.selleckchem.com/products/tram-34.html 375, CI 1.471-3.831; p < 0.001], no second-line therapy (HR 3.425, CI 2.082-5.635, p < 0.001), and application of three agents compared to one agent in first-line therapy (HR 2.798, CI 1.374-5.697; p = 0.005) were associated to decreased overall survival after start of first-line systemic therapy. Termination of second-line treatment because of deterioration of the general condition was the only independent negative prognostic factor (HR 4.202, CI 1.091-16.129; p = 0.037) after start of second-line systemic therapy. This study offers useful information, mainly prior to the availability of immunotherapy, on patient characteristics, treatment patterns, and survival in a German real-world population. This study offers useful information, mainly prior to the availability of immunotherapy, on patient characteristics, treatment patterns, and survival in a German real-world population. Several studies have evaluated the role of delayed initiation of adjuvant chemotherapy (AC) in breast cancer (BC), but the results have remained controversial and an optimal time has not been defined. Our aim was to determine the effect of time to starting AC from the date of surgery on survival of BC patients, based on estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status, using data from the National Cancer Database (NCDB). A total of 332,927 Stage I-III BC patients who received AC from 2010 to 2016 were analyzed. We included all ER, PR and HER2 statuses and excluded patients with stage 4 and stage 0 (DCIS) disease. The cohort was divided into five groups based on the time of initiating AC from the date of the most definitive surgery i.e., ≤ 30days, 31-60days, 61-90days, 91-120days and > 120days. They were further divided into five subgroups based on the receptor status. Hazard ratio (HR) estimates and Kaplan-Meier (KM) analysis shows that starting AC by 31-60days shows the best surviv

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