Predictors of Adjuvant Hormone Therapy Discontinuation Identified

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Predictors for discontinuing adjuvant hormone therapy in patients with breast cancer have been identified.
Predictors for discontinuing adjuvant hormone therapy in patients with breast cancer have been identified.

Predictors for discontinuing adjuvant hormone therapy in patients with breast cancer have been identified, according to a study published online ahead of print this week in the Journal of Clinical Oncology

This study was a follow-up of a record-linkage study over a 5-year period in patients with breast cancer who received their first prescription of tamoxifen or aromatase inhibitors. The data were from Stockholm-Gotland Breast Cancer Register, Swedish Prescribed Drug Register, and self-reported questionnaire.  

The baseline predictors to discontinue adjuvant hormone therapy were family history of ovarian cancer (HR=1.55; 95% CI: 1.19, 2.02), less than 40 years of age (HR=1.39; 95% CI: 1.08, 1.78), 65 years of age and older (HR=1.15; 95% CI: 1.03, 1.28), Charlson comorbidity index of 2 or greater (HR=1.35; 95% CI: 1.03, 1.76), use of analgesics (HR=1.33; 95% CI: 1.16, 1.52), hypnotics/sedatives (HR=1.24; 95% CI: 1.07, 1.43), gastrointestinal drugs (HR=1.25; 95% CI: 1.08, 1.43), and hormone replacement therapy (HR=1.27; 95% CI: 1.08, 1.49).

RELATED: Worse Outcomes in Patients Managed Without Radiotherapy After Chemo for Breast Cancer

The predictors associated with increased risk of discontinuation during the next four years were use of analgesics (HR=1.22; 95% CI: 1.08, 1.37), hypnotics/sedatives (HR=1.21; 95% CI: 1.07, 1.37), antidepressants (HR=1.22; 95% CI: 1.06, 1.40), gastrointestinal drugs (HR=1.27; 95% CI: 1.13, 1.43), and switching therapy between tamoxifen and aromatase inhibitors (HR=1.50; 95% CI: 1.23,1.83) during the first year of hormonal treatment. 

The findings suggest that these predictors can be useful to developing targeted interventions to prevent discontinuation of therapy and ultimately improve breast cancer outcomes.

Reference

  1. He W, Fang F, Varnum C, et al. Predictors of discontinuation of adjuvant hormone therapy in patients with breast cancer. J Clin Oncol. 2015. [Epub ahead of print]. doi: 10.1200/JCO.2014.59.3673.

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