Simulation modeling of breast cancer endocrine therapy duration by patient and tumor characteristics.
Simulation modeling of breast cancer endocrine therapy duration by patient and tumor characteristics.
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DOI：
10.1002/cam4.4084
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发表时间：
2022-01
期刊：
影响因子：
4
通讯作者：
Mandelblatt J
中科院分区：
文献类型：
--
作者：
Chandler Y;Schechter C;Jayasekera J;Isaacs C;Kurian AW;Cadham C;Mandelblatt J
对于侵袭性雌激素受体（ER）阳性乳腺癌的女性，建议将内分泌治疗延长5至10年。我们评估了额外五年治疗的益处和危害。一个已建立的癌症干预和监测网络（CISNET）模型使用了一个终生范围，其中包括关于25-79岁新诊断为ER+非转移性乳腺癌的美国女性多胎生育队列的治疗疗效和不良事件以及其他原因死亡率的国家和临床试验数据。我们假设100%使用治疗。结局包括生命年（LY）、质量调整生命年（Qs）和乳腺癌死亡率。结果以3%的折扣。敏感度分析测试了15年的时间范围和替代假设。在25-49岁的女性中，延长他莫昔芬治疗时间将乳腺癌死亡的终生概率从11.9%降低到9.3%（绝对差异为2.6%）。这意味着每名女性增加0.77 LY（281天）（未贴现）。不良事件将这一增益降低至0.44 Qs，贴现后，增益为0.20 Qs（73天）/女性。在50-79岁的女性中，延长芳香化酶抑制剂治疗的绝对获益较小，并且获益被不良事件抵消（损失0.06折扣Qs）。对于淋巴结阳性和阴性癌症的女性来说，延长内分泌治疗的收益更大，但只有25-49岁和50-59岁的女性才能获得净QALY收益。所有增益均降低，治疗完成率低于100%。内分泌治疗从5年延长至10年，可适度改善乳腺癌的终生预后，但在某些女性中，治疗相关的不良事件可能超过获益。模拟建模用于评估激素受体阳性非转移性乳腺癌女性的扩展内分泌治疗。结果表明，内分泌治疗从5年延长到10年，在某些群体中适度提高了生命年，但不良事件可能超过获益。
Extending endocrine therapy from 5 to 10 years is recommended for women with invasive estrogen receptor (ER)‐positive breast cancers. We evaluated the benefits and harms of the five additional years of therapy. An established Cancer Intervention and Surveillance Network (CISNET) model used a lifetime horizon with national and clinical trial data on treatment efficacy and adverse events and other‐cause mortality among multiple birth cohorts of U.S. women ages 25–79 newly diagnosed with ER+, non‐metastatic breast cancer. We assumed 100% use of therapy. Outcomes included life years (LYs), quality‐adjusted life years (QALYs), and breast cancer mortality. Results were discounted at 3%. Sensitivity analyses tested a 15‐year time horizon and alternative assumptions. Extending tamoxifen therapy duration among women ages 25–49 reduced the lifetime probability of breast cancer death from 11.9% to 9.3% (absolute difference 2.6%). This translates to a gain of 0.77 LYs (281 days)/woman (undiscounted). Adverse events reduce this gain to 0.44 QALYs and after discounting, gains are 0.20 QALYs (73 days)/woman. Extended aromatase inhibitor therapy in women 50–79 had small absolute benefits and gains were offset by adverse events (loss of 0.06 discounted QALYs). There were greater gains with extended endocrine therapy for women with node‐positive versus negative cancers, but only women ages 25–49 and 50–59 had a net QALY gain. All gains were reduced with less than 100% treatment completion. The extension of endocrine therapy from 5 to 10 years modestly improved lifetime breast cancer outcomes, but in some women, treatment‐related adverse events may outweigh benefits. Simulation modeling was used to evaluate extended endocrine therapy for women with hormone receptor‐positive non‐metastatic breast cancer. Results indicate that extension of endocrine therapy from 5 to 10 years modestly improves life years in some groups but adverse events may outweigh benefits.
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影响因子：
45.3
作者：
Ganz, Patricia A.;Petersen, Laura;Crespi, Catherine M.
通讯作者：
Crespi, Catherine M.
影响因子：
168.9
作者：
Davies, Christina;Pan, Hongchao;Godwin, Jon;Gray, Richard;Arriagada, Rodrigo;Raina, Vinod;Abraham, Mirta;Medeiros Alencar, Victor Hugo;Badran, Atef;Bonfill, Xavier;Bradbury, Joan;Clarke, Michael;Collins, Rory;Davis, Susan R.;Delmestri, Antonella;Forbes, John F.;Haddad, Peiman;Hou, Ming-Feng;Inbar, Moshe;Khaled, Hussein;Kielanowska, Joanna;Kwan, Wing-Hong;Mathew, Beela S.;Mittra, Indraneel;Mueller, Bettina;Nicolucci, Antonio;Peralta, Octavio;Pernas, Fany;Petruzelka, Lubos;Pienkowski, Tadeusz;Radhika, Ramachandran;Rajan, Balakrishnan;Rubach, Maryna T.;Tort, Sera;Urrutia, Gerard;Valentini, Miriam;Wang, Yaochen;Peto, Richard
通讯作者：
Peto, Richard
为绝经前乳腺癌调整辅助内分泌疗法。
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
影响因子：
7.2
作者：
Mariotto, Angela B.;Wang, Zhuoqiao;Feuer, Eric J.
通讯作者：
Feuer, Eric J.
DOI：
10.1177/0272989x17700624
发表时间：
2018-04
期刊：
Medical decision making : an international journal of the Society for Medical Decision Making
影响因子：
--
作者：
Mandelblatt JS;Near AM;Miglioretti DL;Munoz D;Sprague BL;Trentham-Dietz A;Gangnon R;Kurian AW;Weedon-Fekjaer H;Cronin KA;Plevritis SK
通讯作者：
Plevritis SK