Patient preferences and adherence to adjuvant GnRH analogs among premenopausal women with hormone receptor positive breast cancer.
Patient preferences and adherence to adjuvant GnRH analogs among premenopausal women with hormone receptor positive breast cancer.
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DOI：
10.1007/s10549-021-06368-4
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发表时间：
2021-11
影响因子：
3.8
通讯作者：
Sardesai S
中科院分区：
文献类型：
--
作者：
Sukumar JS;Quiroga D;Kassem M;Grimm M;Shinde NV;Appiah L;Palettas M;Stephens J;Gatti-Mays ME;Pariser A;Cherian M;Stover DG;Williams N;Van Deusen J;Wesolowski R;Lustberg M;Ramaswamy B;Sardesai S
绝经前激素受体（HR）阳性乳腺癌（BC）的辅助卵巢功能抑制（OFS）可提高生存率。对辅助促性腺激素释放激素类似物（GnRHa）的依从性仍然是一个挑战，并且与毒性和不方便的胃肠外给药相关。本研究的目的是描述真实世界的依从性模式和患者对辅助GnRHa的偏好。我们分析了2000年1月至2017年12月期间患有非转移性HR阳性BC的绝经前女性的医疗记录;参与者在俄亥俄州州立大学接受每月一次的戈舍瑞林或亮丙瑞林辅助治疗。收集的数据包括人口统计学、临床病理学特征和OFS依从性/副作用。我们将非依从性定义为3年内因其他原因而停用GnRHa，而不是转换为替代OFS，延迟> 7天给药或错过剂量。卡方检验评估临床特征与结局之间的相关性。共有325例患者符合入组资格。其中，119例（37%）患者不依从GnRHa; 137例（42%）在初始GnRHa后接受了择期双侧输卵管卵巢切除术。选择手术的患者报告的潮热（74% vs 48%，p < 0.001）、关节痛（46% vs 30%，p = 0.003）和阴道干燥（37% vs 21%，p = 0.001）显著高于继续使用GnRHa的患者。超过三分之一的患者未依从辅助GnRHa治疗，几乎一半的患者开始GnRHa治疗后接受了手术消融。这些高频率突出了OFS的真实模式。此外，治疗毒性可能会影响OFS方式的个人偏好。针对辅助GnRHa非依从性预测因素的个性化实践对于优化症状、依从性和生存率至关重要。
Adjuvant ovarian function suppression (OFS) in premenopausal hormone receptor (HR) positive breast cancer (BC) improves survival. Adherence to adjuvant gonadotropin-releasing hormone analogs (GnRHa) remains a challenge and is associated with toxicities and inconvenient parenteral administration. The goal of this study was to describe real-world adherence patterns and patient preferences surrounding adjuvant GnRHa. We analyzed the medical records of premenopausal women with non-metastatic HR positive BC from January 2000 to December 2017; participants received adjuvant monthly goserelin or leuprolide at The Ohio State University. Data collected included demographics, clinicopathologic characteristics, and OFS adherence/side effects. We defined non-adherence as discontinuation of GnRHa within 3 years for a reason other than switching to an alternate OFS, delay > 7 days from a dose, or a missed dose. Chi-square tests assessed associations between clinical characteristics and outcomes. A total of 325 patients met eligibility. Of these, 119 (37%) patients were non-adherent to GnRHa; 137 (42%) underwent elective bilateral salpingo-oophorectomy after initial GnRHa. Those opting for surgery reported significantly more hot flashes (74% vs 48%, p < 0.001), arthralgias (46% vs 30%, p = 0.003), and vaginal dryness (37% vs 21%, p = 0.001) compared with patients remaining on GnRHa. Non-adherence to adjuvant GnRHa occurred in over a third of patients and almost half the patients initiating GnRHa underwent subsequent surgical ablation. These high frequencies highlight real-world patterns of OFS. Additionally, treatment toxicities may impact personal preference of OFS modality. Personalized practices to target predictors of adjuvant GnRHa non-adherence are critical to optimize symptoms, adherence, and survivorship.
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DOI：
10.1056/nejmoa1803164
发表时间：
2018-07-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Francis PA;Pagani O;Fleming GF;Walley BA;Colleoni M;Láng I;Gómez HL;Tondini C;Ciruelos E;Burstein HJ;Bonnefoi HR;Bellet M;Martino S;Geyer CE Jr;Goetz MP;Stearns V;Pinotti G;Puglisi F;Spazzapan S;Climent MA;Pavesi L;Ruhstaller T;Davidson NE;Coleman R;Debled M;Buchholz S;Ingle JN;Winer EP;Maibach R;Rabaglio-Poretti M;Ruepp B;Di Leo A;Coates AS;Gelber RD;Goldhirsch A;Regan MM;SOFT and TEXT Investigators and the International Breast Cancer Study Group
通讯作者：
SOFT and TEXT Investigators and the International Breast Cancer Study Group
DOI：
10.1056/nejmoa1804710
发表时间：
2018-07-12
期刊：
The New England journal of medicine
影响因子：
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作者：
Sparano JA;Gray RJ;Makower DF;Pritchard KI;Albain KS;Hayes DF;Geyer CE Jr;Dees EC;Goetz MP;Olson JA Jr;Lively T;Badve SS;Saphner TJ;Wagner LI;Whelan TJ;Ellis MJ;Paik S;Wood WC;Ravdin PM;Keane MM;Gomez Moreno HL;Reddy PS;Goggins TF;Mayer IA;Brufsky AM;Toppmeyer DL;Kaklamani VG;Berenberg JL;Abrams J;Sledge GW Jr
通讯作者：
Sledge GW Jr
影响因子：
45.3
作者：
Bellet, Meritxell;Gray, Kathryn P.;Regan, Meredith M.
通讯作者：
Regan, Meredith M.
影响因子：
45.3
作者：
He, Wei;Fang, Fang;Czene, Kamila
通讯作者：
Czene, Kamila
影响因子：
2.1
作者：
Hsieh, A. H. -C.;Kichenadasse, G.;Koczwara, B.
通讯作者：
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