Abstract
BackgroundTreatment of postmenopausal, hormone receptor-positive metastatic breast cancer (MBC) patients varies despite clear therapy guidelines, favoring endocrine treatment (ET). Aim of this study was to analyze persistence of palliative aromatase inhibitor (AI) monotherapy in MBC patients.MethodsEvAluate-TM is a prospective, multicenter, noninterventional study to evaluate treatment with letrozole in postmenopausal women with hormone receptor–positive breast cancer. To assess therapy persistence, defined as the time from therapy start to the end of the therapy (TTEOT), two pre-specified study visits took place after 6 and 12 months. Competing risk survival analyses were performed to identify patient and tumor characteristics that predict TTEOT.ResultsOut of 200 patients, 66 patients terminated treatment prematurely, 26 (13%) of them due to causes other than disease progression. Persistence rate for reasons other than progression at 12 months was 77.7%. Persistence was lower in patients who reported any adverse event (AE) in the first 30 days of ET (89.5% with no AE and 56% with AE). Furthermore, patients had a lower persistence if they reported compliance problems in the past before letrozole treatment.ConclusionsDespite suffering from a life-threatening disease, AEs of an AI will result in a relevant number of treatment terminations that are not related to progression. Some subgroups of patients have very low persistence rates. Especially with regard to novel endocrine combination therapies, these data imply that some groups of patients will need special attention to guide them through the therapy process.Trial registrationClinical Trials Number: CFEM345DDE19
Highlights
Treatment of postmenopausal, hormone receptor-positive metastatic breast cancer (MBC) patients varies despite clear therapy guidelines, favoring endocrine treatment (ET)
Despite suffering from a life-threatening disease, adverse event (AE) of an aromatase inhibitor (AI) will result in a relevant number of treatment terminations that are not related to progression
With regard to novel endocrine combination therapies, these data imply that some groups of patients will need special attention to guide them through the therapy process
Summary
Hormone receptor-positive metastatic breast cancer (MBC) patients varies despite clear therapy guidelines, favoring endocrine treatment (ET). Endocrine therapy (ET) is the recommended treatment in patients with hormone receptor-positive, advanced breast cancer. ET has recently become the focus of MBC treatment as novel combination therapies are being developed for hormone receptor-positive, advanced breast cancer patients to overcome endocrine resistance [3]. In the adjuvant setting, which has been investigated in several trials, compliance and persistence of therapy with tamoxifen or AIs in postmenopausal breast cancer patients decrease over the course of treatment [8,9,10,11], which, in turn, is associated with reduced disease-free survival (DFS) [12]. In contrast, only few studies have analyzed patient compliance with ET, and not much is known about possible risk factors [15, 16]
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