Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy
dc.contributor.author | Kidwell, Kelley M. | |
dc.contributor.author | Harte, Steven E. | |
dc.contributor.author | Hayes, Daniel F. | |
dc.contributor.author | Storniolo, Anna Maria | |
dc.contributor.author | Carpenter, Janet | |
dc.contributor.author | Flockhart, David A. | |
dc.contributor.author | Stearns, Vered | |
dc.contributor.author | Clauw, Daniel J. | |
dc.contributor.author | Williams, David A. | |
dc.contributor.author | Henry, N. Lynn | |
dc.contributor.department | Department of Medicine, IU School of Medicine | en_US |
dc.date.accessioned | 2015-11-13T19:45:11Z | |
dc.date.available | 2015-11-13T19:45:11Z | |
dc.date.issued | 2014-08-15 | |
dc.description.abstract | BACKGROUND: Aromatase inhibitor (AI) therapy results in substantial survival benefits for patients with hormone receptor-positive breast cancer. The rates of poor adherence and discontinuation of AI therapy are high, primarily because of treatment-related toxicities like musculoskeletal pain. Although pain-related symptoms may worsen during AI therapy, the authors hypothesized that nonpersistence with AI therapy was associated with symptoms that were present before treatment initiation. METHODS: Postmenopausal women initiating AI therapy who were enrolled in a prospective clinical trial completed questionnaires at baseline to assess sleep, fatigue, mood, and pain. Reasons for treatment discontinuation during the first year of treatment were recorded. Associations between baseline patient-reported symptoms and treatment discontinuation because of toxicity were identified using logistic regression. RESULTS: Four hundred forty-nine patients were evaluable. The odds of treatment discontinuation were higher in patients who reported a greater number of symptoms before AI initiation. Baseline poor sleep quality was associated with early treatment discontinuation, with an odds ratio (OR) of 1.91 (95% confidence interval [CI], 1.26-2.89; P = .002). Baseline presence of tired feeling and forgetfulness had similar ORs for discontinuation (tired feeling: OR, 1.76; 95% CI, 1.15-2.67; P = .009; forgetfulness: OR, 1.66; 95% CI, 1.11-2.48; P = .015). An increasing total number of baseline symptoms was associated with an increased likelihood of treatment discontinuation, with an OR of 1.89 (95% CI, 1.20-2.96; P = .006) for 3 to 5 symptoms versus 0 to 2 symptoms. CONCLUSIONS: Symptom clusters in breast cancer survivors that are present before the initiation of adjuvant AI therapy may have a negative impact on a patient's persistence with therapy. Interventions to manage these symptoms may improve breast cancer outcomes and quality of life. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Kidwell, K. M., Harte, S. E., Hayes, D. F., Storniolo, A. M., Carpenter, J., Flockhart, D. A., … Henry, N. L. (2014). Patient-Reported Symptoms and Discontinuation of Adjuvant Aromatase Inhibitor Therapy. Cancer, 120(16), 2403–2411. http://doi.org/10.1002/cncr.28756 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/7449 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wiley | en_US |
dc.relation.isversionof | 10.1002/cncr.28756 | en_US |
dc.relation.journal | Cancer | en_US |
dc.rights | IUPUI Open Access Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Aromatase inhibitor | en_US |
dc.subject | Breast cancer | en_US |
dc.subject | Nonpersistence | en_US |
dc.subject | Patient-reported outcomes | en_US |
dc.subject | Symptoms | en_US |
dc.title | Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy | en_US |
dc.type | Article | en_US |