Meta-analysis of effect of hormone therapies on lipid levels in breast cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18243-e18243
Author(s):  
Hsin-Hui Huang ◽  
Marnie Bertolet ◽  
Emma Barinas-Mitchell ◽  
Brenda Diergaarde ◽  
Chung-Chou Chang
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Breast Cancer Patients ◽  
Lipid Levels ◽  
Adjuvant Hormone Therapy

e18243 Background: Breast cancer (BC) patients with hormone-sensitive tumors often receive adjuvant hormone therapy for an extended period. How this affects lipid levels is not known. This study evaluated the relationship between dyslipidemia, a cardiovascular disease risk factor, and use of adjuvant hormone therapy among breast cancer patients. Methods: Randomized clinical trials for adjuvant hormone treatment in post-menopausal BC patients without residual cancer after primary treatment that reported lipid levels were identified in PubMed and EMBASE (N = 13). Bayesian network meta-analysis for longitudinal data was used to evaluate each drug’s effect on the mean changes in lipid levels from baseline. Key covariates were examined to determine heterogeneity of treatment effects; consistency of estimates was assessed using the arm-based method. Results: Toremifene improved all lipids more than any other hormone drug studied (see Table). Most aromatase inhibitors (AIs) did not significantly impact lipids. Age, baseline lipid value, and prior usage of Tamoxifen modified the drug effects on most lipids. However, these modifications do not change the overall conclusion. Conclusions: Selective estrogen receptor modulators (SERMs) are beneficial to most lipid profiles, but AIs do not have consistent impacts on lipids. Tailoring hormone drug prescriptions based on medical conditions of BC patients is recommended. [Table: see text]

Non-pharmacological therapies for depressive symptoms in breast cancer patients: Systematic review and meta-analysis of randomized clinical trials

The Breast ◽  
2019 ◽  
Vol 44 ◽  
pp. 135-143 ◽  
Author(s):  
Liliana Coutiño-Escamilla ◽  
Maricela Piña-Pozas ◽  
Aurelio Tobías Garces ◽  
Brenda Gamboa-Loira ◽  
Lizbeth López-Carrillo
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Depressive Symptoms ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Breast Cancer Patients

scholarly journals The early discontinuation of adjuvant hormone therapy is associated with a poor prognosis in Japanese breast cancer patients

Surgery Today ◽  
2013 ◽  
Vol 44 (10) ◽  
pp. 1841-1846 ◽  
Author(s):  
Kenji Taketani ◽  
Eriko Tokunaga ◽  
Nami Yamashita ◽  
Kimihiro Tanaka ◽  
Sayuri Akiyoshi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Breast Cancer Patients ◽  
Early Discontinuation ◽  
Adjuvant Hormone Therapy

Abstract P124: Network Meta-analysis of the Effects of Breast Cancer Hormone Therapy on Changes in Lipid Profiles

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Hsin-Hui Huang ◽  
Emma Barinas-Mitchell ◽  
Brenda Diergaarde ◽  
Chung-Chou Chang ◽  
Marnie Bertolet
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Randomized Clinical Trials ◽  
Early Stage ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Adjuvant Hormone Therapy ◽  
The Impact

Introduction: Adjuvant hormone therapy prolongs survival of patients with early-stage hormone receptor-positive breast cancer (BC). For postmenopausal patients, aromatase inhibitors (AIs) have been shown to improve disease free survival compared to tamoxifen, but the impact on overall survival has been inconsistent. A meta-analysis showed higher risk of cardiovascular diseases (CVDs) for patients taking AIs. Deteriorating lipids induced by AIs may contribute to this result. This analysis aims to compare the effects of hormone therapeutic options on changes in lipids from published randomized clinical trials (RCTs). Methods: RCTs evaluating effects of adjuvant hormone therapy on lipids (total cholesterol, high-density lipoprotein cholesterol (HDLc), low density lipoprotein cholesterol (LDLc), and/or triglycerides) in postmenopausal early-stage BC patients published in PubMed and Embase, prior to Jan. 31, 2016 were reviewed. Bayesian network meta-analysis was used to compare effects of placebo, selective estrogen receptor modulators (SERMs- tamoxifen and toremifene) and AIs (letrozole, anastrozole, and exemstane) on lipids across longitudinal time points. Heterogeneity was examined by meta-regressions adjusting for mean age, baseline lipid value, and prior tamoxifen use. An arm-based random effect model tested the consistency of the direct and indirect evidence of the drug effects. Results: We identified 17 articles from 13 RCTs for a total of 1,913 subjects. The Table summarizes the results, with statistically significant results bolded. Toremifene significantly improved all lipids and was the best choice regardless of covariate adjustment, while tamoxifen had weaker but significant LDLc lowering but opposite HDLc/triglyceride effects to toremifene. AIs generally had little effect on lipids. Conclusions: In general, AIs tend to have worse effects on lipids than SERMs, while only toremifene had beneficial effects on all lipid values. Patients on AIs with high risk of CVD should monitor their lipids.

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.

Adjuvant hormone therapy use in early-stage breast cancer patients insured by the New York State Medicaid program.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 6031-6031
Author(s):  
R. L. Yung ◽  
M. J. Hassett ◽  
K. Chen ◽  
F. C. Gesten ◽  
P. R. Roohan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New York ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Early Stage ◽  
New York State ◽  
Breast Cancer Patients ◽  
Medicaid Program ◽  
Adjuvant Hormone Therapy ◽  
York State

Early-stage breast cancer patients reporting difficulty sleeping, mood issues, or pain are more likely to refuse adjuvant hormone therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12065-e12065
Author(s):  
Christian A. Thomas
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy

e12065 Background: Adjuvant hormone therapy is a crucial part of the treatment for patients with early stage breast cancer and an important quality measure for programs such as QOPI and the oncology care model (OCM). However, it is not known which factors influence some patients with early stage breast cancer to decline adjuvant hormone therapy. We hypothesized that specific self-reported symptoms might impact a patient’s decision to accept or decline adjuvant hormone therapy. Methods: Patients with stage 0 or I breast cancer were identified by chart review from 2011-2016 and de-identified. On the day patients received a recommendation for adjuvant treatment the following patient reported outcome measures (PROs) were analyzed: difficulty sleeping (DS), fatigue (F), mood (M such as anxiety and depression), and pain (P) on a 0-4 symptom scale based on CTCAE v. 4. PROs were then linked with a patient’s decision to accept or decline adjuvant therapy. Results: A total of 287 patients with stage 0 (n = 80) or stage I (n = 207) breast cancer were identified. 38 stage O and 103 stage I patients had evaluable PROs on the same day a recommendation for adjuvant hormone therapy was made. Overall 18/38 (47.4%) of stage 0 patients and 90 of 103 (87.4%) of stage I patients accepted adjuvant treatment. Stage 0 patients declining adjuvant therapy reported any grade of PROs: DS (40%, n = 8), F (35%, n = 7), M (35%, n = 7), P (20%, n = 4). Stage 0 patients accepting treatment reported: DS (22%, n = 4), F (44%, n = 8), M (6%, n = 1), P (20%, n = 4). Stage I patients who declined treatment reported: DS (54%, n = 7), F (46%, n = 6), M (38%, n = 5), P (62%, n = 8). Stage I patients accepting treatment reported: DS (41%, n = 37), F (49%, n = 44), M (31%, n = 28), P (36%, n = 32). Conclusions: Early stage breast cancer patients declining adjuvant hormone therapy are more likely to self report symptoms such as difficulty sleeping, mood disturbances (anxiety, depression), and pain than those accepting treatment.

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