Importance of endocrine treatment adherence and persistence in breast cancer survivorship: a systematic review.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
04 Jul 2023
Historique:
received: 02 02 2023
accepted: 28 06 2023
medline: 6 7 2023
pubmed: 5 7 2023
entrez: 4 7 2023
Statut: epublish

Résumé

Adjuvant endocrine treatment is essential for treating luminal subtypes of breast cancer, which constitute 75% of all breast malignancies. However, the detrimental side effects of treatment make it difficult for many patients to complete the guideline-required treatment. Such non-adherence may jeopardize the lifesaving ability of anti-estrogen therapy. In this systematic review, we aimed to assess the consequences of non-adherence and non-persistence from available studies meeting strict statistical and clinical criteria. A systematic literature search was performed using several databases, yielding identification of 2,026 studies. After strict selection, 14 studies were eligible for systematic review. The review included studies that examined endocrine treatment non-adherence (patients not taking treatment as prescribed) or non-persistence (patients stopping treatment prematurely), in terms of the effects on event-free survival or overall survival among women with non-metastatic breast cancer. We identified 10 studies measuring the effects of endocrine treatment non-adherence and non-persistence on event-free survival. Of these studies, seven showed significantly poorer survival for the non-adherent or non-persistent patient groups, with hazard ratios (HRs) ranging from 1.39 (95% CI, 1.07 to 1.53) to 2.44 (95% CI, 1.89 to 3.14). We identified nine studies measuring the effects of endocrine treatment non-adherence and non-persistence on overall survival. Of these studies, seven demonstrated significantly reduced overall survival in the groups with non-adherence and non-persistence, with HRs ranging from 1.26 (95% CI, 1.11 to 1.43) to 2.18 (95% CI, 1.99 to 2.39). The present systematic review demonstrates that non-adherence and non-persistence to endocrine treatment negatively affect event-free and overall survival. Improved follow-up, with focus on adherence and persistence, is vital for improving health outcomes among patients with non-metastatic breast cancer.

Identifiants

pubmed: 37403065
doi: 10.1186/s12885-023-11122-8
pii: 10.1186/s12885-023-11122-8
pmc: PMC10320891
doi:

Substances chimiques

Adjuvants, Immunologic 0
Antineoplastic Agents, Hormonal 0

Types de publication

Systematic Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

625

Informations de copyright

© 2023. The Author(s).

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Auteurs

Finn Magnus Eliassen (FM)

Department of Surgery, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway. fime@sus.no.

Vibeke Blåfjelldal (V)

Department of Surgery, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.

Thomas Helland (T)

Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.

Cathrine Fonnesbech Hjorth (CF)

Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark.

Kari Hølland (K)

Division of Research, University of Stavanger, Stavanger, Norway.

Lise Lode (L)

Department of Gastrointestinal Surgery, Hvidovre Hospital, Copenhagen, Denmark.

Bjørn-Erik Bertelsen (BE)

Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.

Emiel A M Janssen (EAM)

Department of Pathology, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.
Department of Chemistry, Biosciences and Environmental Engineering, University of Stavanger, Stavanger, Norway.

Gunnar Mellgren (G)

Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.

Jan Terje Kvaløy (JT)

Department of Research, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.
Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway.

Håvard Søiland (H)

Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Research, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.

Tone Hoel Lende (TH)

Department of Surgery, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.

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