1. Treatment utilization and non-drug interventions for vasomotor symptoms in breast cancer survivors taking endocrine therapy: Real-world findings from the United States and Europe.
- Author
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Kingsberg S, Banks V, Caetano C, Janssenswillen C, Moeller C, Schoof N, Harvey M, Scott M, and Nappi RE
- Subjects
- Humans, Female, Middle Aged, Europe, Cross-Sectional Studies, United States, Aged, Antineoplastic Agents, Hormonal therapeutic use, Antineoplastic Agents, Hormonal adverse effects, Aromatase Inhibitors adverse effects, Aromatase Inhibitors therapeutic use, Nonprescription Drugs therapeutic use, Adult, Life Style, Vasomotor System drug effects, Vasomotor System physiopathology, Quality of Life, Breast Neoplasms drug therapy, Breast Neoplasms complications, Cancer Survivors statistics & numerical data, Hot Flashes, Tamoxifen therapeutic use, Tamoxifen adverse effects
- Abstract
Objectives: Vasomotor symptoms induced by endocrine therapy are common in breast cancer survivors and a risk factor for therapy discontinuation and lower quality of life. The REALISE study evaluated the real-world treatment landscape in breast cancer survivors with vasomotor symptoms taking endocrine therapy, including pharmaceuticals, lifestyle changes, and over-the-counter products., Study Design: Secondary analysis of the Adelphi Vasomotor Disease Specific Programme™, a large cross-sectional point-in-time survey and chart review conducted in the US and five European countries (February-October 2020). Oncologists provided demographic, clinical, and treatment data for adult breast cancer survivors with induced vasomotor symptoms taking endocrine therapy (tamoxifen or aromatase inhibitors); patients voluntarily completed self-report surveys on their symptom severity, concomitant sleep and/or mood symptoms, lifestyle changes, and use of over-the-counter products., Main Outcome Measures: Patient characteristics; vasomotor symptom severity; use of pharmaceuticals, lifestyle changes, and over-the-counter products (from pre-defined lists); lines of treatment., Results: Overall, 77 oncologists reported data for 618 breast cancer survivors, of whom 183 (29.6 %) completed self-report forms. Physicians classified 420 (68.0 %) women as experiencing moderate-severe vasomotor symptoms, of whom 66.9 % were receiving treatment. In total, 15.2 % of all breast cancer survivors were prescribed systemic hormone therapy. Venlafaxine (24.7 %), citalopram (16.5 %), and paroxetine (13.6 %) were the most commonly prescribed nonhormonal medications. Lifestyle changes (77.8 %) and over-the-counter products (61.6 %) were common, especially in patients with concomitant sleep and/or mood symptoms., Conclusions: Despite contraindications, a relatively large proportion of treatment-seeking breast cancer survivors with vasomotor symptoms were prescribed systemic hormone therapy. This, combined with high patient-reported use of lifestyle changes and over-the-counter products, suggests a need for symptomatic relief and demand for new nonhormonal alternatives with established safety profiles in this population., Competing Interests: Declaration of competing interest S.K. is an employee of University Hospitals Cleveland Medical Center and has received consulting fees or honoraria from: Astellas, Alloy, Bayer, Daré, Freya, Reunion Neuroscience, Materna Medical, Madorra, Ms. Medicine, Palatin Technologies, Pfizer, Sprout, Strategic Science Technologies, and TherapeuticsMD; and stock options from Reunion Neuroscience, Alloy, and Materna Medical. N.S., C.M., and S.S. are employees of Bayer AG, Germany. C.C. and C.J. are employees of Bayer Consumer Care, Switzerland. M.S. and M.H. are employees of Adelphi Real World, UK. L.H. is an employee of Bayer US. V.B. was an employee of Bayer, UK at the time of the study. Rossella E. Nappi had past financial relationships (lecturer, member of advisory boards and/or consultant) with Boehringer Ingelheim, Ely Lilly, Endoceutics, Palatin Technologies, Pfizer Inc., Procter & Gamble Co, TEVA Women's Health Inc. and Zambon SpA. At present, she has on-going relationships with Abbott, Astellas, Bayer HealthCare AG, Besins Healthcare, Exeltis, Fidia, Gedeon Richter, HRA Pharma, Merck & Co, Novo Nordisk, Organon & Co, Shionogi Limited, Theramex, and Viatris., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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