Breast cancer research and treatment · 2025
Side effects and adherence trajectories of adjuvant endocrine therapy in breast cancer patients: results from the VICAN2 study.
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Radwan Eqbal, Memoli Victoria, Seguin Lorène, Mancini Julien, Bouhnik Anne-Déborah
Аннотация
PURPOSE: Adjuvant endocrine therapy (AET) lowers breast cancer recurrence risk and improves overall survival. However, some women have suboptimal adherence, mainly due to difficulties coping with side effects. We identified different long-term AET adherence trajectories and investigated associated side effects.
METHODS: We used multisource data from the French national VICAN2 study, which interviewed women two years after breast cancer diagnosis. We measured AET adherence using the monthly proportion of days covered (PDC) over 41 months (median) after enrolment in VICAN2. Group-Based Trajectory Modelling (GBTM) helped identify adherence trajectory groups.
RESULTS: The 637 women included were categorized into three trajectories: continuous optimal adherence (70.6%), late non-adherence (19.8%), and near-simultaneous discontinuation (9.6%). The most common side effects were hot flashes (78.2%) and joint pain (74.4%). Living alone, always or regularly feeling sad or blue, not receiving chemotherapy, and switching AET were all associated with increased odds of belonging to the near-simultaneous discontinuation group. Younger age (44-54 years), low household income, no contact with a social worker, not receiving chemotherapy, being first prescribed aromatase inhibitors for AET, always experiencing hot flashes, and occasionally experiencing joint pain were all associated with increased odds of belonging to the late non-adherence group.
CONCLUSION: This study provides valuable insight into the dynamics of AET adherence patterns and related side effects. Identifying women who experience hot flashes and joint pain two years after diagnosis may strongly predict future non-adherence. Managing these side effects could foster long-term adherence and optimise health outcomes.
METHODS: We used multisource data from the French national VICAN2 study, which interviewed women two years after breast cancer diagnosis. We measured AET adherence using the monthly proportion of days covered (PDC) over 41 months (median) after enrolment in VICAN2. Group-Based Trajectory Modelling (GBTM) helped identify adherence trajectory groups.
RESULTS: The 637 women included were categorized into three trajectories: continuous optimal adherence (70.6%), late non-adherence (19.8%), and near-simultaneous discontinuation (9.6%). The most common side effects were hot flashes (78.2%) and joint pain (74.4%). Living alone, always or regularly feeling sad or blue, not receiving chemotherapy, and switching AET were all associated with increased odds of belonging to the near-simultaneous discontinuation group. Younger age (44-54 years), low household income, no contact with a social worker, not receiving chemotherapy, being first prescribed aromatase inhibitors for AET, always experiencing hot flashes, and occasionally experiencing joint pain were all associated with increased odds of belonging to the late non-adherence group.
CONCLUSION: This study provides valuable insight into the dynamics of AET adherence patterns and related side effects. Identifying women who experience hot flashes and joint pain two years after diagnosis may strongly predict future non-adherence. Managing these side effects could foster long-term adherence and optimise health outcomes.