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June 25, 2014
Most Older Patients Initiate Therapy for Nonmetastatic
Breast Cancer Washington, DC—The overwhelming majority of women over 65 with nonmetastatic breast cancer initiated hormone therapy at an oncologist’s recommendation, according to a new study. The report, published online by the Journal of Clinical Oncology, determined that only 14% of patients failed to comply with the prescription for either an aromatase inhibitor or tamoxifen, which prevent tumors from using estrogen to fuel growth. “Women 65 years of age and older comprise about half of patients with breast cancer, but some studies have suggested this group initiates therapy less often and discontinues treatment more frequently than younger or middle aged women,” said the study’s lead author, Vanessa B. Sheppard, PhD, associate professor of oncology and assistant director of health disparities research at Georgetown Lombardi Comprehensive Cancer Center. “We found a more positive picture of use—although more than half of patients discontinued use before the five years of recommended treatment, non-initiation of starting treatment was only 14%,” Sheppard added. “This is reassuring, as it’s important for women to give themselves a chance for the best outcome possible, regardless of their age.” Conducted over a 7-year period at 78 U.S. institutions and clinics, the study enrolled 1,062 elderly women ages 65 to 91 with locally invasive cancer that had not metastasized. Sheppard suggested that patients in the study characterized as frail or “prefrail" may have better reason to refuse to begin breast cancer treatment compared to women who are more robust. “It may be that these women, with the concurrence of their physicians, felt they would not live long enough to benefit from the therapy given competing health conditions, and they also may have wanted to avoid any toxicities from treatment,” she explained. Results indicated that the discontinuation rate within 5 years was 51.5% and that the risk of discontinuation increased with older age but decreased with advanced stages of the disease.
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U.S. Pharmacist Social Connect
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