Treatment interruption and discontinuation of hormonal therapy in hormone receptor-positive breast cancer patients

2020 ◽  
Vol 184 (3) ◽  
pp. 665-674
Author(s):  
Daqin Mao ◽  
Hilal Hachem ◽  
Hong Chang ◽  
Danai Dima ◽  
Joshua Dower ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Treatment Interruption ◽  
Breast Cancer Patients ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

scholarly journals 3365 Treatment Interruptions and Early Discontinuation of Hormone Therapy in Hormone Receptor-Positive Breast Cancer Patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 157-157
Author(s):  
Daqin Mao ◽  
Hong Chang ◽  
Angie Mae Rodday ◽  
Hilal Hachem ◽  
John K. Erban ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
Treatment Interruption ◽  
Breast Cancer Patients ◽  
Early Discontinuation ◽  
Adjuvant Hormone Therapy ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

OBJECTIVES/SPECIFIC AIMS: (1) To evaluate the association of patient and clinical factors with adherence to adjuvant hormone therapy (HT). (2) To examine the association of HT-related symptoms and the extent of remediation with early discontinuation of hormone therapy. METHODS/STUDY POPULATION: Retrospective cohort study of risk factors for interruption and early discontinuation of adjuvant hormone therapy in hormone receptor-positive nonmetastatic breast cancer patients diagnosed between 2009 and 2015. This study will include incident hormone receptor-positive breast cancer patients who initiated their HT and were followed at Tufts MC until Dec 31, 2016. Primary data source is electronic medical records (EMRs) RESULTS/ANTICIPATED RESULTS: The primary outcome of this study is early discontinuation to HT, defined as the first treatment gap of greater than or equal to 180 days following the initiation of HT. Treatment interruption, defined as any patient- or provider-initiated treatment gap of ≥ 2 weeks, will be examined as the secondary endpoint. Any HT-related symptoms occurred during a follow-up interval will be captured and categorized into five major types (i.e., vasomotor, neuropsychological, gastrointestinal, gynecological, and musculoskeletal symptoms). Onset and duration of a HT-related symptom will be recorded. Severity of the symptoms will also be rated by clinical oncologists. Remediations in response to HT- related symptoms will be collected and categorized into to two groups (pharmacological or non-pharmacological) and whether they were patient- or provider-initiated. Response to a remediation is defined as complete relief, partial relied, no relief, or with worsening symptoms. Response to a treatment change (i.e., HT switch or hold) was collected separately but using the same criteria. Analyses will be performed on the association between patient and clinical factors with rates of nonadherence (unplanned treatment interruption and/or early discontinuation) of hormone therapy, respectively. We also will explore whether patients with elevated symptoms and/or incomplete remediation will have earlier discontinuation of hormone therapy. DISCUSSION/SIGNIFICANCE OF IMPACT: Through formal chart review, we will establish a dataset that contains highly detailed information about treatment-emergent symptoms and remediations, which will enable us to quantitatively assess the impact of these treatment factors on adherence to hormone therapy for breast cancer. The in-depth analysis of risk factors associated with nonadherence to hormone therapy will inform development of interventions to improve cancer outcomes.

Social support at diagnosis and noninitiation, discontinuation, and nonadherence to adjuvant hormonal therapy in the Pathways Study.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 7-7 ◽  
Author(s):  
Candyce Kroenke ◽  
Dawn L. Hershman ◽  
Sara Adams ◽  
Marilyn L. Kwan ◽  
Lawrence H. Kushi
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancer Patients ◽  
Positive Interaction ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

7 Background: Exceedingly little research has examined associations between social support and adherence to adjuvant hormonal therapy (AHT) in breast cancer patients. We evaluated associations of social support and noninitiation and discontinuation of, and nonadherence to, AHT in a large, Northern California cohort. Methods: This study included 3,382 women from the Pathways Study who were diagnosed with stages I-III hormone receptor positive breast cancer from 2006-2013 and responded to the Medical Outcomes Study social support survey approximately two months following diagnosis. We used logistic regression to evaluate associations between social support and noninitiation ( < 2 consecutive prescription fills within the first year after diagnosis). Among those who initiated treatment, we used proportional hazards regression to evaluate associations of social support, discontinuation ( > 90 day gap), and nonadherence ( < 80% medical possession ratio) to treatment. Results: Of those who initiated treatment (79%), approximately one fourth either discontinued AHT or were nonadherent. In multivariable-adjusted analyses, adjusted for sociodemographic characteristics, disease severity, other treatment, and presence of comorbidity, women with low (OR = 1.31, 95% CI: 1.06-1.62) and moderate (OR = 1.18, 95% CI: 0.96-1.46) levels of social support were more likely not to initiate AHT treatment, compared to those with high support. Emotional/informational support, tangible support, and positive interaction were each significantly related to noninitiation; affection was not. Of those who initiated treatment, women with low (HR = 1.30, 95% CI: 1.07-1.58) or moderate (HR = 1.19, 95% CI: 0.98-1.44) levels of support were more likely to discontinue treatment. Furthermore, women with low (HR = 1.37, 95% CI: 1.11-1.88) or moderate (HR = 1.24, 95% CI: 1.01-1.52) support had higher nonadherence to treatment. Conclusions: Hormone receptor positive breast cancer patients with low levels of social support had higher noninitiation and discontinuation of, and nonadherence to, AHT. Information on social support may help clinicians determine who is at greater risk of AHT nonadherence.

scholarly journals Analytical validation of CanAssist-Breast: an immunohistochemistry based prognostic test for hormone receptor positive breast cancer patients

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Arun Kumar Attuluri ◽  
Chandra Prakash V. Serkad ◽  
Aparna Gunda ◽  
Charusheila Ramkumar ◽  
Chetana Basavaraj ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
Breast Cancer Patients ◽  
Analytical Validation ◽  
Prognostic Test ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

Similar Efficacy for Ovarian Ablation Compared With Cyclophosphamide, Methotrexate, and Fluorouracil: From a Randomized Comparison of Premenopausal Patients With Node-Positive, Hormone Receptor–Positive Breast Cancer

2006 ◽  
Vol 24 (31) ◽  
pp. 4956-4962 ◽  
Author(s):  
Bent Ejlertsen ◽  
Henning T. Mouridsen ◽  
Maj-Britt Jensen ◽  
Nils-Olof Bengtsson ◽  
Jonas Bergh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
Hazard Ratio ◽  
Breast Cancer Patients ◽  
Ovarian Ablation ◽  
Hormone Receptor Positive ◽  
Disease Free ◽  
Positive Breast Cancer

Purpose To compare the efficacy of ovarian ablation versus chemotherapy in early breast cancer patients with hormone receptor–positive disease. Patients and Methods We conducted an open, randomized, multicenter trial including premenopausal breast cancer patients with hormone receptor–positive tumors and either axillary lymph node metastases or tumors with a size of 5 cm or more. Patients were randomly assigned to ovarian ablation by irradiation or to nine courses of chemotherapy with intravenous cyclophosphamide, methotrexate, and fluorouracil (CMF) administered every 3 weeks. Results Between 1990 and May 1998, 762 patients were randomly assigned, and the present analysis is based on 358 first events. After a median follow-up time of 8.5 years, the unadjusted hazard ratio for disease-free survival in the ovarian ablation group compared with the CMF group was 0.99 (95% CI, 0.81 to 1.22). After a median follow-up time of 10.5 years, overall survival (OS) was similar in the two groups, with a hazard ratio of 1.11 (95% CI, 0.88 to 1.42) for the ovarian ablation group compared with the CMF group. Conclusion In this study, ablation of ovarian function in premenopausal women with hormone receptor–positive breast cancer had a similar effect to CMF on disease-free and OS. No significant interactions were demonstrated between treatment modality and hormone receptor content, age, or any of the well-known prognostic factors.

Clinicopathologic features of hormone‐receptor‐positive breast cancer patients with late recurrence

2019 ◽  
Vol 25 (1) ◽  
pp. 9-15
Author(s):  
Takeshi Murata ◽  
Hiromitsu Jinno ◽  
Maiko Takahashi ◽  
Masayuki Shimoda ◽  
Tetsu Hayashida ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
Late Recurrence ◽  
Clinicopathologic Features ◽  
Breast Cancer Patients ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer
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