Document Detail


Half of breast cancer patients discontinue tamoxifen and any endocrine treatment before the end of the recommended treatment period of 5 years: a population-based analysis.
MedLine Citation:
PMID:  20058066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Observational studies on long-term endocrine treatment among breast cancer patients have presented discontinuation rates on tamoxifen, but lack information on the continuance of any endocrine treatment [both tamoxifen and aromatase inhibitors (AIs)] within the same cohort. In this study we determined switching rates from tamoxifen to AIs, discontinuation rates of tamoxifen only, discontinuation rates of any endocrine treatment and determinants of first treatment switch and treatment discontinuation. Patients with early stage breast cancer (stage I-IIIa) starting on tamoxifen were selected from the linked Eindhoven Cancer Registry-PHARMO RLS cohort in the period 1998-2006. Continuous use (allowing a 60 days gap between refills) of tamoxifen only and any endocrine treatment were determined after various follow-up periods: 1, 2, 3, 4, and 5 years. Time to first switch from tamoxifen to an AI was assessed. Cox regression was used to identify determinants of first treatment switch, discontinuation of tamoxifen, and discontinuation of any endocrine treatment. A total of 1,451 new early stage breast cancer patients started on tamoxifen. Of those, 380 had a treatment switch to an AI during follow-up. Of the patients followed for 5 years, 40% continuously used tamoxifen, which was 49% for any endocrine treatment. Older age (older than 70 versus 50-69 years) was independently associated with increased discontinuation of tamoxifen and any endocrine therapy. Patients with two or more concomitant diseases (versus no comorbidity) showed an increased likelihood to stop any endocrine treatment or switch treatment from tamoxifen to an AI. In conclusion, up to half of the breast cancer patients starting tamoxifen continued 5 years of endocrine treatment. Identification of patients at risk of discontinuation will assist in the development of interventions to improve treatment continuation comparable to that of patients included in clinical trials.
Authors:
Myrthe P P van Herk-Sukel; Lonneke V van de Poll-Franse; Adri C Voogd; Grard A P Nieuwenhuijzen; Jan Willem W Coebergh; Ron M C Herings
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-08
Journal Detail:
Title:  Breast cancer research and treatment     Volume:  122     ISSN:  1573-7217     ISO Abbreviation:  Breast Cancer Res. Treat.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111104     Medline TA:  Breast Cancer Res Treat     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  843-51     Citation Subset:  IM    
Affiliation:
PHARMO Institute for Drug Outcomes Research, P.O. Box 85222, 3508 AE, Utrecht, The Netherlands. myrthe.van.herk@pharmo.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents, Hormonal / therapeutic use*
Aromatase Inhibitors / therapeutic use*
Breast Neoplasms / drug therapy*,  pathology
Endocrine System / drug effects*
Female
Follow-Up Studies
Humans
Middle Aged
Netherlands / epidemiology
Survival Rate
Tamoxifen / therapeutic use*
Time Factors
Treatment Outcome
Treatment Refusal*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Aromatase Inhibitors; 10540-29-1/Tamoxifen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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