| Title |
Prospective assessment of patient-reported outcomes and estradiol and drug concentrations in patients experiencing toxicity from adjuvant aromatase inhibitors
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, April 2017
|
| DOI | 10.1007/s10549-017-4260-2 |
| Pubmed ID | |
| Authors |
Kunal C. Kadakia, Kelley M. Kidwell, Nicholas J. Seewald, Claire F. Snyder, Anna Maria Storniolo, Julie L. Otte, David A. Flockhart, Daniel F. Hayes, Vered Stearns, N. Lynn Henry |
| Abstract |
Aromatase inhibitors (AI), which decrease circulating estradiol concentrations in post-menopausal women, are associated with toxicities that limit adherence. Approximately one-third of patients will tolerate a different AI after not tolerating the first. We report the effect of crossover from exemestane to letrozole or vice versa on patient-reported outcomes (PROs) and whether the success of crossover is due to lack of estrogen suppression. Post-menopausal women enrolled on a prospective trial initiating AI therapy for early-stage breast cancer were randomized to exemestane or letrozole. Those that discontinued for intolerance were offered protocol-directed crossover to the other AI after a washout period. Changes in PROs, including pain [Visual Analog Scale (VAS)] and functional status [Health Assessment Questionnaire (HAQ)], were compared after 3 months on the first versus the second AI. Estradiol and drug concentrations were measured. Eighty-three patients participated in the crossover protocol, of whom 91.3% reported improvement in symptoms prior to starting the second AI. Functional status worsened less after 3 months with the second AI (HAQ mean change AI #1: 0.2 [SD 0.41] vs. AI #2: -0.05 [SD 0.36]; p = 0.001); change in pain scores was similar between the first and second AI (VAS mean change AI #1: 0.8 [SD 2.7] vs. AI #2: -0.2 [SD 2.8]; p = 0.19). No statistical differences in estradiol or drug concentrations were found between those that continued or discontinued AI after crossover. Although all AIs act via the same mechanism, a subset of patients intolerant to one AI report improved PROs with a different one. The mechanism of this tolerance remains unknown, but does not appear to be due to non-adherence to, or insufficient estrogen suppression by, the second AI. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 70 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 14% |
| Student > Master | 9 | 13% |
| Student > Bachelor | 9 | 13% |
| Other | 4 | 6% |
| Student > Ph. D. Student | 4 | 6% |
| Other | 13 | 19% |
| Unknown | 21 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 24% |
| Nursing and Health Professions | 7 | 10% |
| Psychology | 6 | 9% |
| Agricultural and Biological Sciences | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Other | 13 | 19% |
| Unknown | 23 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 May 2017.
All research outputs
#18,547,867
of 22,971,207 outputs
Outputs from Breast Cancer Research and Treatment
#3,739
of 4,675 outputs
Outputs of similar age
#235,313
of 309,827 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#66
of 109 outputs
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