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Clinical Trial
. 2012;17(1):55-63.
doi: 10.1634/theoncologist.2011-0037. Epub 2011 Dec 30.

Age-specific nonpersistence of endocrine therapy in postmenopausal patients diagnosed with hormone receptor-positive breast cancer: a TEAM study analysis

Willemien van de Water  1 , Esther Bastiaannet, Elysée T M Hille, Elma M Meershoek-Klein Kranenbarg, Hein Putter, Caroline M Seynaeve, Robert Paridaens, Anton J M de Craen, Rudi G J Westendorp, Gerrit-Jan Liefers, Cornelis J H van de Velde
Affiliations
Clinical Trial

Age-specific nonpersistence of endocrine therapy in postmenopausal patients diagnosed with hormone receptor-positive breast cancer: a TEAM study analysis

Willemien van de Water et al. Oncologist. 2012.

Abstract

Background: Early discontinuation of adjuvant endocrine therapy may affect the outcome of treatment in breast cancer patients. The aim of this study was to assess age-specific persistence and age-specific survival outcome based on persistence status.

Methods: Patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational trial were included. Nonpersistence was defined as discontinuing the assigned endocrine treatment within 1 year of follow-up because of adverse events, intercurrent illness, patient refusal, or other reasons. Endpoints were the breast cancer-specific and overall survival times. Analyses were stratified by age at diagnosis (<65 years, 65-74 years, ≥75 years).

Results: Overall, 3,142 postmenopausal breast cancer patients were included: 1,682 were aged <65 years, 951 were aged 65-74 years, and 509 were aged ≥75 years. Older age was associated with a higher proportion of nonpersistence within 1 year of follow-up. In patients aged <65 years, nonpersistent patients had lower breast cancer-specific and overall survival probabilities. In patients aged 65-74 years and patients aged ≥75 years, the survival times of persistent and nonpersistent patients were similar.

Conclusion: Nonpersistence within 1 year of follow-up was associated with lower breast cancer-specific and overall survival probabilities in patients aged <65 years, but it was not associated with survival outcomes in patients aged 65-74 years or in patients aged ≥75 years. These results suggest that extrapolation of outcomes from a young to an elderly breast cancer population may be insufficient and urge age-specific breast cancer studies.

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Conflict of interest statement

Disclosures: Willemien van de Water: None; Esther Bastiaannet: None; Elysée T.M. Hille: None; Elma M. Meershoek-Klein Kranenbarg: None; Hein Putter: None; Caroline M. Seynaeve: Pfizer (support for travel expenses), Sanofi-Aventis (C/A); Robert Paridaens: Received investigator fees paid to the hospital for participation in the trial; Anton J.M. de Craen: None; Rudi G.J. Westendorp: None; Gerrit-Jan Liefers: None; Cornelis J.H. van de Velde: None.

Figures

Figure 1.
Figure 1.
Study flow chart. Abbreviations: BE, Belgium; NL, The Netherlands; TEAM, Tamoxifen Exemestane Adjuvant Multinational.
Figure 2.
Figure 2.
Cumulative incidence of death resulting from breast cancer and from other causes by persistence status at 1 year follow-up, by age at diagnosis.
See this image and copyright information in PMC

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