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Erschienen in: Supportive Care in Cancer 9/2017

24.03.2017 | Original Article

A prospective study of aromatase inhibitor therapy initiation and self-reported side effects

verfasst von: Lisa Gallicchio, Carla Calhoun, Kathy Helzlsouer

Erschienen in: Supportive Care in Cancer | Ausgabe 9/2017

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Abstract

Purpose

The objective of this study was to examine the associations between aromatase inhibitors (AIs) and side effects less frequently reported in the literature, including difficulty concentrating, forgetfulness, hair loss, and numbness in the extremities.

Methods

Data were analyzed from a cohort of 146 breast cancer patients initiating AI therapy and followed for 1 year and a cohort of 144 postmenopausal women without a history of cancer followed for 6 months. At baseline (prior to AI therapy for breast cancer patients), and at 3 months, 6 months, and 1 year (for breast cancer patients only), a comprehensive questionnaire was administered that ascertained data on symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression for new onset of symptoms among the breast cancer patients compared to the women without a history of cancer.

Results

Among the breast cancer patients, 34.2% were treated with chemotherapy prior to AI treatment. Over the first 6 months of AI treatment, breast cancer patients had significantly higher odds of reporting new onset of forgetfulness (OR 4.00; 95% CI 1.67, 9.59), difficulty concentrating (OR 2.73; 95% CI 1.29; 5.78), hair loss (OR 4.12; 95% CI 1.86, 9.17), and numbness/tingling in the extremities (OR 2.47; 95% CI 1.09, 5.62) compared to women without a history of cancer. Similar increases in odds were observed for the subgroup of women not treated with chemotherapy versus the comparison group.

Conclusions

AI-related symptoms should be monitored and addressed so that adherence to therapy is maintained.
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Literatur
1.
Zurück zum Zitat Breast International Group 1-98 Collaborative Group, Thurlimann B, Keshaviah A, Coates AS et al (2005) A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 353:2747–2757CrossRef Breast International Group 1-98 Collaborative Group, Thurlimann B, Keshaviah A, Coates AS et al (2005) A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 353:2747–2757CrossRef
2.
Zurück zum Zitat Coates AS, Keshaviah A, Thurlimann B et al (2007) Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Oncol 25:486–492CrossRefPubMed Coates AS, Keshaviah A, Thurlimann B et al (2007) Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Oncol 25:486–492CrossRefPubMed
3.
Zurück zum Zitat Coombes RC, Kilburn LS, Snowdon CF et al (2007) Survival and safety of exemestane versus tamoxifen after 2-3 years’ tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet 369:559–570CrossRefPubMed Coombes RC, Kilburn LS, Snowdon CF et al (2007) Survival and safety of exemestane versus tamoxifen after 2-3 years’ tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet 369:559–570CrossRefPubMed
4.
Zurück zum Zitat Arimidex Tamoxifen, Alone or in Combination (ATAC) Trialists’ Group, Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M (2008) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol 9:45–53CrossRef Arimidex Tamoxifen, Alone or in Combination (ATAC) Trialists’ Group, Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M (2008) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol 9:45–53CrossRef
5.
Zurück zum Zitat Campos SM (2004) Aromatase inhibitors for breast cancer in postmenopausal women. Oncologist 9:126–136CrossRefPubMed Campos SM (2004) Aromatase inhibitors for breast cancer in postmenopausal women. Oncologist 9:126–136CrossRefPubMed
6.
Zurück zum Zitat Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134:459–478CrossRefPubMedPubMedCentral Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134:459–478CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Kadakia KC, Snyder CF, Kidwell KM, Seewald NJ, Flockhart DA, Skaar TC, Desta Z, Rae JM, Otte JL, Carpenter JS (2016) Patient-reported outcomes and early discontinuation in aromatase inhibitor-treated postmenopausal women with early stage breast cancer. Oncologist 21:539–546CrossRefPubMedPubMedCentral Kadakia KC, Snyder CF, Kidwell KM, Seewald NJ, Flockhart DA, Skaar TC, Desta Z, Rae JM, Otte JL, Carpenter JS (2016) Patient-reported outcomes and early discontinuation in aromatase inhibitor-treated postmenopausal women with early stage breast cancer. Oncologist 21:539–546CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S, Hayden J, Tarpinian K, Yakim E, Flockhart DA et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30:936–942CrossRefPubMedPubMedCentral Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S, Hayden J, Tarpinian K, Yakim E, Flockhart DA et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30:936–942CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Partridge AH, LaFountain A, Mayer E, Taylor BS, Winer E, Asnis-Alibozek A (2008) Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol 26:556–562CrossRefPubMed Partridge AH, LaFountain A, Mayer E, Taylor BS, Winer E, Asnis-Alibozek A (2008) Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol 26:556–562CrossRefPubMed
10.
Zurück zum Zitat Helzlsouer KJ, Gallicchio L, MacDonald R, Wood B, Rushovich E (2012) A prospective study of aromatase inhibitor therapy, vitamin D, C-reactive protein and musculoskeletal symptoms. Breast Cancer Res Treat 131:277–285CrossRefPubMed Helzlsouer KJ, Gallicchio L, MacDonald R, Wood B, Rushovich E (2012) A prospective study of aromatase inhibitor therapy, vitamin D, C-reactive protein and musculoskeletal symptoms. Breast Cancer Res Treat 131:277–285CrossRefPubMed
11.
12.
Zurück zum Zitat Felson DT, Cummings SR (2005) Aromatase inhibitors and the syndrome of arthralgias with estrogen deprivation. Arthritis Rheum 52:2594–2598CrossRefPubMed Felson DT, Cummings SR (2005) Aromatase inhibitors and the syndrome of arthralgias with estrogen deprivation. Arthritis Rheum 52:2594–2598CrossRefPubMed
13.
Zurück zum Zitat Henry NL, Giles JT, Stearns V (2008) Aromatase inhibitor-associated musculoskeletal symptoms: etiology and strategies for management. Oncology (Williston Park) 22:1401–1408 Henry NL, Giles JT, Stearns V (2008) Aromatase inhibitor-associated musculoskeletal symptoms: etiology and strategies for management. Oncology (Williston Park) 22:1401–1408
14.
Zurück zum Zitat Lombard JM, Zdenkowski N, Wells K, Beckmore C, Reaby L, Forbes JF, Chirgwin J (2016) Aromatase inhibitor induced musculoskeletal syndrome: a significant problem with limited treatment options. Support Care Cancer 24:2139–2146CrossRefPubMed Lombard JM, Zdenkowski N, Wells K, Beckmore C, Reaby L, Forbes JF, Chirgwin J (2016) Aromatase inhibitor induced musculoskeletal syndrome: a significant problem with limited treatment options. Support Care Cancer 24:2139–2146CrossRefPubMed
15.
Zurück zum Zitat Dent SF, Gaspo R, Kissner M, Pritchard KI (2011) Aromatase inhibitor therapy: toxicities and management strategies in the treatment of postmenopausal women with hormone-sensitive early breast cancer. Breast Cancer Res Treat 126:295–310CrossRefPubMed Dent SF, Gaspo R, Kissner M, Pritchard KI (2011) Aromatase inhibitor therapy: toxicities and management strategies in the treatment of postmenopausal women with hormone-sensitive early breast cancer. Breast Cancer Res Treat 126:295–310CrossRefPubMed
16.
Zurück zum Zitat Ganz PA, Petersen L, Bower JE, Crespi CM (2016) Impact of adjuvant endocrine therapy on quality of life and symptoms: observational data over 12 months from the mind-body study. J Clin Oncol 34:816–824CrossRefPubMedPubMedCentral Ganz PA, Petersen L, Bower JE, Crespi CM (2016) Impact of adjuvant endocrine therapy on quality of life and symptoms: observational data over 12 months from the mind-body study. J Clin Oncol 34:816–824CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Gallicchio L, MacDonald R, Wood B, Rushovich E, Helzlsouer KJ (2012) Menopausal-type symptoms among breast cancer patients on aromatase inhibitor therapy. Climacteric 15:339–349CrossRefPubMed Gallicchio L, MacDonald R, Wood B, Rushovich E, Helzlsouer KJ (2012) Menopausal-type symptoms among breast cancer patients on aromatase inhibitor therapy. Climacteric 15:339–349CrossRefPubMed
18.
Zurück zum Zitat Gallicchio L, Calhoun C, Helzlsouer KJ (2013) Aromatase inhibitor therapy and hair loss among breast cancer survivors. Breast Cancer Res Treat 142:435–443CrossRefPubMed Gallicchio L, Calhoun C, Helzlsouer KJ (2013) Aromatase inhibitor therapy and hair loss among breast cancer survivors. Breast Cancer Res Treat 142:435–443CrossRefPubMed
19.
Zurück zum Zitat Ganz PA, Petersen L, Castellon SA, Bower JE, Silverman DH, Cole SW, Irwin MR, Belin TR (2014) Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study. J Clin Oncol 32:3559–3567CrossRefPubMedPubMedCentral Ganz PA, Petersen L, Castellon SA, Bower JE, Silverman DH, Cole SW, Irwin MR, Belin TR (2014) Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study. J Clin Oncol 32:3559–3567CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Collins B, Mackenzie J, Stewart A, Bielajew C, Verma S (2009) Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study. Psychooncology 18:811–821CrossRefPubMed Collins B, Mackenzie J, Stewart A, Bielajew C, Verma S (2009) Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study. Psychooncology 18:811–821CrossRefPubMed
21.
Zurück zum Zitat Inglis H, Boyle FM, Friedlander ML, Watson SL (2015) Dry eyes and AIs: if you don’t ask you won’t find out. Breast 24:694–698CrossRefPubMed Inglis H, Boyle FM, Friedlander ML, Watson SL (2015) Dry eyes and AIs: if you don’t ask you won’t find out. Breast 24:694–698CrossRefPubMed
22.
Zurück zum Zitat Gallicchio L, Calhoun C, Riseberg D, Helzlsouer KJ (2017) Cardiovascular health among black and white breast cancer patients initiating aromatase inhibitor therapy. Breast J Gallicchio L, Calhoun C, Riseberg D, Helzlsouer KJ (2017) Cardiovascular health among black and white breast cancer patients initiating aromatase inhibitor therapy. Breast J
23.
Zurück zum Zitat Merriman JD, Sereika SM, Brufsky AM, McAuliffe PF, McGuire KP, Myers JS, Phillips ML, Ryan CM, Gentry AL, Jones LD, Bender CM (2017) Trajectories of self-reported cognitive function in postmenopausal women during adjuvant systemic therapy for breast cancer. Psychooncology Merriman JD, Sereika SM, Brufsky AM, McAuliffe PF, McGuire KP, Myers JS, Phillips ML, Ryan CM, Gentry AL, Jones LD, Bender CM (2017) Trajectories of self-reported cognitive function in postmenopausal women during adjuvant systemic therapy for breast cancer. Psychooncology
24.
Zurück zum Zitat Chelune CJ, Heaton RK, Lehman RAW (1986) Neuropsychological and personality correlates of patients’ complaints of disability. In: Goldstein G, Tarter RE (eds) Advances in clinical neuropsychology. Volume 3. Plenum Press, New York, pp 95–126CrossRef Chelune CJ, Heaton RK, Lehman RAW (1986) Neuropsychological and personality correlates of patients’ complaints of disability. In: Goldstein G, Tarter RE (eds) Advances in clinical neuropsychology. Volume 3. Plenum Press, New York, pp 95–126CrossRef
25.
Zurück zum Zitat Le Rhun E, Delbeuck X, Lefeuvre-Plesse C, Kramar A, Skrobala E, Pasquier F, Bonneterre J (2015) A phase III randomized multicenter trial evaluating cognition in post-menopausal breast cancer patients receiving adjuvant hormonotherapy. Breast Cancer Res Treat 152:569–580CrossRefPubMed Le Rhun E, Delbeuck X, Lefeuvre-Plesse C, Kramar A, Skrobala E, Pasquier F, Bonneterre J (2015) A phase III randomized multicenter trial evaluating cognition in post-menopausal breast cancer patients receiving adjuvant hormonotherapy. Breast Cancer Res Treat 152:569–580CrossRefPubMed
26.
Zurück zum Zitat Hurria A, Patel SK, Mortimer J, Luu T, Somlo G, Katheria V, Ramani R, Hansen K, Feng T, Chuang C, Geist CL, Silverman DH (2014) The effect of aromatase inhibition on the cognitive function of older patients with breast cancer. Clin Breast Cancer 14:132–140CrossRefPubMed Hurria A, Patel SK, Mortimer J, Luu T, Somlo G, Katheria V, Ramani R, Hansen K, Feng T, Chuang C, Geist CL, Silverman DH (2014) The effect of aromatase inhibition on the cognitive function of older patients with breast cancer. Clin Breast Cancer 14:132–140CrossRefPubMed
27.
Zurück zum Zitat Jenkins VA, Ambroisine LM, Atkins L, Cuzick J, Howell A, Fallowfield LJ (2008) Effects of anastrozole on cognitive performance in postmenopausal women: a randomised, double-blind chemoprevention trial (IBIS II). Lancet Oncol 9:953–961CrossRefPubMed Jenkins VA, Ambroisine LM, Atkins L, Cuzick J, Howell A, Fallowfield LJ (2008) Effects of anastrozole on cognitive performance in postmenopausal women: a randomised, double-blind chemoprevention trial (IBIS II). Lancet Oncol 9:953–961CrossRefPubMed
28.
Zurück zum Zitat Shanmugan S, Epperson CN (2014) Estrogen and the prefrontal cortex: towards a new understanding of estrogen’s effects on executive functions in the menopause transition. Hum Brain Mapp 35:847–865CrossRefPubMed Shanmugan S, Epperson CN (2014) Estrogen and the prefrontal cortex: towards a new understanding of estrogen’s effects on executive functions in the menopause transition. Hum Brain Mapp 35:847–865CrossRefPubMed
29.
Zurück zum Zitat Hederstierna C, Hultcrantz M, Collins A, Rosenhall U (2010) The menopause triggers hearing decline in healthy women. Hear Res 259:31–35CrossRefPubMed Hederstierna C, Hultcrantz M, Collins A, Rosenhall U (2010) The menopause triggers hearing decline in healthy women. Hear Res 259:31–35CrossRefPubMed
30.
Zurück zum Zitat Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, Kwan M, Gomez SL, Neugut AI (2011) Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat 126:529–537CrossRefPubMed Hershman DL, Shao T, Kushi LH, Buono D, Tsai WY, Fehrenbacher L, Kwan M, Gomez SL, Neugut AI (2011) Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat 126:529–537CrossRefPubMed
31.
Zurück zum Zitat Chirgwin JH, Giobbie-Hurder A, Coates AS et al (2016) Treatment adherence and its impact on disease-free survival in the breast international group 1-98 trial of tamoxifen and Letrozole, alone and in sequence. J Clin Oncol 34:2452–2459CrossRefPubMedPubMedCentral Chirgwin JH, Giobbie-Hurder A, Coates AS et al (2016) Treatment adherence and its impact on disease-free survival in the breast international group 1-98 trial of tamoxifen and Letrozole, alone and in sequence. J Clin Oncol 34:2452–2459CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Hsieh KP, Chen LC, Cheung KL, Chang CS, Yang YH (2014) Interruption and non-adherence to long-term adjuvant hormone therapy is associated with adverse survival outcome of breast cancer women—an Asian population-based study. PLoS One 9:e87027CrossRefPubMedPubMedCentral Hsieh KP, Chen LC, Cheung KL, Chang CS, Yang YH (2014) Interruption and non-adherence to long-term adjuvant hormone therapy is associated with adverse survival outcome of breast cancer women—an Asian population-based study. PLoS One 9:e87027CrossRefPubMedPubMedCentral
Metadaten
Titel
A prospective study of aromatase inhibitor therapy initiation and self-reported side effects
verfasst von
Lisa Gallicchio
Carla Calhoun
Kathy Helzlsouer
Publikationsdatum
24.03.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 9/2017
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3678-8

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