Patient preferences and adherence to adjuvant GnRH analogs among premenopausal women with hormone receptor positive breast cancer

Purpose Adjuvant ovarian function suppression (OFS) in premenopausal hormone receptor (HR) positive breast cancer (BC) improves survival. Adherence to adjuvant gonadotropin-releasing hormone analogs (GnRHa) remains a challenge and is associated with toxicities and inconvenient parenteral administrat...

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Bibliographic Details
Published in:Breast cancer research and treatment 2021-11, Vol.190 (2), p.183-188
Main Authors: Sukumar, Jasmine S., Quiroga, Dionisia, Kassem, Mahmoud, Grimm, Michael, Shinde, Namrata Vilas, Appiah, Leslie, Palettas, Marilly, Stephens, Julie, Gatti-Mays, Margaret E., Pariser, Ashley, Cherian, Mathew, Stover, Daniel G., Williams, Nicole, Van Deusen, Jeffrey, Wesolowski, Robert, Lustberg, Maryam, Ramaswamy, Bhuvaneswari, Sardesai, Sagar
Format: Article
Language:English
Subjects:
Ablation (Surgery)
Analysis
Antineoplastic Agents, Hormonal - adverse effects
Breast cancer
Breast Neoplasms - drug therapy
Cancer research
Chemotherapy, Adjuvant
Demography
Female
Gonadotropin
Gonadotropin-releasing hormone
Gonadotropin-Releasing Hormone - therapeutic use
Gonadotropins
Goserelin - adverse effects
Humans
Medical colleges
Medical records
Medicine
Medicine & Public Health
Menopause
Metastases
Metastasis
Oncology
Ovarian cancer
Ovariectomy
Patient compliance
Patient Preference
Patients
Pituitary (anterior)
Pituitary hormones
Premenopause
Reproductive status
Review
Survival
Tamoxifen - therapeutic use
Women
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Summary:Purpose Adjuvant ovarian function suppression (OFS) in premenopausal hormone receptor (HR) positive breast cancer (BC) improves survival. Adherence to adjuvant gonadotropin-releasing hormone analogs (GnRHa) remains a challenge and is associated with toxicities and inconvenient parenteral administration. The goal of this study was to describe real-world adherence patterns and patient preferences surrounding adjuvant GnRHa. Methods We analyzed the medical records of premenopausal women with non-metastatic HR positive BC from January 2000 to December 2017; participants received adjuvant monthly goserelin or leuprolide at The Ohio State University. Data collected included demographics, clinicopathologic characteristics, and OFS adherence/side effects. We defined non-adherence as discontinuation of GnRHa within 3 years for a reason other than switching to an alternate OFS, delay > 7 days from a dose, or a missed dose. Chi-square tests assessed associations between clinical characteristics and outcomes. Results A total of 325 patients met eligibility. Of these, 119 (37%) patients were non-adherent to GnRHa; 137 (42%) underwent elective bilateral salpingo-oophorectomy after initial GnRHa. Those opting for surgery reported significantly more hot flashes (74% vs 48%, p  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-021-06368-4