Early participant-reported symptoms as predictors of adherence to anastrozole in the International Breast Cancer Intervention Studies II
| Autor: | Sestak, I, Smith, S G, Howell, A, Forbes, J F, Cuzick, J |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Endocrine therapy Antineoplastic Agents Hormonal Manchester Cancer Research Centre endocrine therapy Prevention ResearchInstitutes_Networks_Beacons/mcrc Breast Neoplasms Original Articles Anastrozole Middle Aged Medication Adherence Tamoxifen breast cancer Carcinoma Intraductal Noninfiltrating Breast cancer prevention Double-Blind Method Adherence Humans Female adherence Cancer Prevention Aged |
| Zdroj: | Sestak, I, Smith, S G, Howell, A, Forbes, J F & Cuzick, J 2017, ' Early participant-reported symptoms as predictors of adherence to anastrozole in the International Breast Cancer Intervention Studies II ', Annals of Oncology, vol. 29, no. 2, pp. 504-509 . https://doi.org/10.1093/annonc/mdx713 Annals of Oncology |
| ISSN: | 0923-7534 |
| Popis: | Background Anastrozole reduces breast cancer risk in women at high risk, but implementing preventive therapy in clinical practice is difficult. Here, we evaluate adherence to anastrozole in the International Breast Cancer Intervention Study (IBIS)-II prevention and ductal carcinoma in situ (DCIS) trials, and its association with early symptoms. Patients and methods In the prevention trial, 3864 postmenopausal women were randomized to placebo versus anastrozole. A total of 2980 postmenopausal women with DCIS were randomized to tamoxifen versus anastrozole. Adherence to trial medication was calculated using the Kaplan–Meier method and all P-values were two-sided. Results In the prevention trial, adherence was 65.8% [anastrozole (65.7%) versus placebo (65.9%); HR = 0.97 (0.87–1.09), P = 0.6]. Adherence was lower for those reporting arthralgia in the placebo group (P = 0.02) or gynecological symptoms in the anastrozole group (P = 0.003), compared with those not reporting these symptoms at 6 months. In the DCIS study, adherence was 66.7% [anastrozole (67.5%) versus tamoxifen (65.8%); HR = 1.06 (0.94–1.20), P = 0.4]. Hot flashes were associated with greater adherence in the anastrozole arm (P = 0.02). In both studies, symptoms were mostly mild or moderately severe, and adherence decreased with increasing severity for most symptoms. Drop-outs were highest in the first 1.5 years of therapy in both trials. Conclusions In the IBIS-II prevention and DCIS trials, over two-thirds of women were adherent to therapy, with no differences by treatment groups. Participants who reported specific symptoms in the IBIS-II prevention trial had a small but significant effect on adherence, which strengthened as severity increased. Strategies to promote adherence should target the first year of preventive therapy. |
| Databáze: | OpenAIRE |
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