Defining Risk of Late Recurrence in Early-Stage Estrogen Receptor–Positive Breast Cancer: Clinical Versus Molecular Tools

Foldi, Julia; O'Meara, Tess A.; Marczyk, Michał; Sanft, Tara; Silber, Andrea; Pusztai, Lajos

doi:10.1200/jco.18.01933

Cited by 20 publications

(17 citation statements)

References 30 publications

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“…This suggests that understanding of the importance of therapy may not be sufficient for adherence when patients face medication-related side effects that significantly interfere with quality of life. While medical team support and communication are important factors influencing ET adherence [6,9,14,[40][41][42][43][44][45], we did not find that feeling "supported" by the medical team was associated with improved medication adherence. A very low number of survey respondents reported financial concerns related to ET or as a reason for discontinuing therapy.…”

Section: Discussioncontrasting

confidence: 67%

“…Intermittent telehealth visits could also address patient decision resolve, as many patients re-visit their commitment to continue ET multiple times throughout the course of treatment [ 2 ]. Patients may benefit from repeated review of both medication benefits, focusing on absolute, rather than relative benefit , as well as the impact on quality of life during the course of therapy [ 2 , 5 , 18 , 19 , 34 , 37 , 42 , 43 , 62 , 63 ], in a way that more passive reminders do not address.…”

Section: Discussionmentioning

confidence: 99%

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How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

et al. 2020

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Purpose Many patients with hormone receptor-positive (HR+) breast cancer do not adhere to endocrine therapy (ET), and treatment-related side effects are often discussed by participants in online breast cancer forums. Our aim was to survey this unique group of patients about their ET-related experiences. Methods We partnered with patients active in breast cancer social media communities to develop a survey assessing ET-related side effects and medical team communication. Patients with a history of HR+ breast cancer who had received a recommendation to take ET were eligible to participate in the anonymous, online survey. Results Respondents included 2353 women and 54 men. Aromatase inhibitors were the most commonly used medication. Side effects were reported by 91.2%, were more often experienced by women than men (p < 0.001), and were primarily related to medication type. Approximately one-third of respondents discontinued therapy early. While most felt supported by their medical team, 31.5% reported that their side effects were dismissed or minimized. Survey respondents most frequently reported that a healthy diet and exercise, yoga/acupuncture, and vitamins/supplements were helpful in managing ET-related side effects. Conclusions ET-related side effects are very common, and one-third discontinued treatment early. Lifestyle changes and complementary therapies can be important tools for side effect management. One-third of patients did not feel that their side effects were taken seriously. Implications for Cancer Survivors This is the largest survey of ET use by participants in online breast cancer communities. Further research is needed to identify strategies to improve treatment adherence and to better manage ET-related side effects.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

et al. 2020

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“…The data may be critical to an approach of precision endocrine therapy in the care of patients with breast cancer. 31 Our results, other real-world data, and clinical trials are gathering sufficient evidence for the cancer research community and regulatory agencies to consider exclusion of p53-positive and HR-positive breast cancer from endocrine therapy or to use alternative treatment approaches. 8 , 29 , 32 , 33 , 34 , 35 In current practice after TAILORx (Trial Assigning Individualized Options for Treatment) trial results, approximately 70% of patients with HR-positive and ERBB2 -negative early-stage breast cancer receive endocrine therapy alone, which accounts for as much as 50% of all early-stage breast cancers.…”

Section: Discussionmentioning

confidence: 66%

Association of Independent Prognostic Factors and Treatment Modality With Survival and Recurrence Outcomes in Breast Cancer

Nguyen

Yu²,

Reinhold

et al. 2020

JAMA Netw Open

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“…Currently, more and more researches are focused on the role of genes and biomarkers in predicting late recurrence risk besides clinicopathological factors (49) , such as Oncotype DX, MammaPrint, BC Index and circulating tumor cell, which has the potential to optimize the candidates for extended endocrine therapy (31, (50, (51, (52, (53, (54, (55, (56, (57, (58) . Combination of clinicopathological factors, genes and biomarkers may add signi cant prognostic information for late recurrence of BC, and provide more useful reference for future work.…”

Section: Discussionmentioning

confidence: 99%

Establish a Prediction Model for the Recurrence Time of Hormone Receptor Positive /human Epidermal Growth Factor Receptor 2-negative Breast Cancer

Xing

et al. 2021

Preprint

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ObjectivesThis study aimed to develop a model to predict recurrence time of hormone receptor-positive (HR+) /human epidermal growth factor receptor 2 negative (HER2-) breast cancer patients. MethodsWe included HR+ HER2- metastatic breast cancer (MBC) female patients who arrived at the Department of Breast Oncology in Peking University Cancer Hospital. Data were collected through consulting medical records. Patients were divided into early recurrence group and late recurrence group according to disease-free survival (DFS). Predictors of recurrence time were identified and a nomogram was developed and validated using concordance index (C-index), AUC (area under the curve), and calibration plots. ResultsA total of 639 patients coming to the hospital between April 2007 and October 2019 were included. Median DFS was 50.0 months. 382 patients (59.8%) were presented with early recurrence (DFS ≤5 years), and 257 patients (40.2%) were presented with late recurrence (DFS >5 years). A nomogram based on potentially associated clinicopathological factors was developed and validation results showed the nomogram was well-calibrated to predict recurrence time (AUC=0.703, C-index=0.697). ConclusionsWe have established a well-calibrated nomogram through 639 patients. HR+/HER2- BC patients with premenopausal status at initial diagnosis, less positive lymph nodes, lower level of Ki-67 were more common in late recurrence. The nomogram can predict the risk of late recurrence. Prospectively designed studies are needed to further validate our model.

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Defining Risk of Late Recurrence in Early-Stage Estrogen Receptor–Positive Breast Cancer: Clinical Versus Molecular Tools

Cited by 20 publications

References 30 publications

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support

Association of Independent Prognostic Factors and Treatment Modality With Survival and Recurrence Outcomes in Breast Cancer

Establish a Prediction Model for the Recurrence Time of Hormone Receptor Positive /human Epidermal Growth Factor Receptor 2-negative Breast Cancer

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