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Evaluation of endocrine therapy and patients preferences in early breast cancer: results of Elena study

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Abstract

Purpose

The development of the adjuvant therapy requires that clinicians and patients should discuss the magnitude of benefit of treatment for individual patient, estimating the pros and cons and the personal preferences. The aim of the present study was to determine the preferences of women treated with adjuvant hormonal therapy (HT) for breast cancer.

Methods

The analyses were conducted into three different groups of early breast cancer patients to evaluate the survival benefit needed to make treatment worthwhile before starting HT (A), after a few months from the beginning (B) and after several years of HT (C). The questionnaires, showing hypothetical scenarios based on potential survival times and rates without HT, were used to determine the lowest gains women judged necessary to make the treatment worthwhile.

Results

A total of 452 patients were included in the study: 149 in group A, 150 in group B and 153 in group C. In group C, 65% of patients were receiving HT with aromatase inhibitors (with or without a LHRH analogue). In the groups A, B, C 8%, 20% and 26%, respectively, received adjuvant chemotherapy. Overall, 355 women (79%) had children. The responses were quite similar between the three groups. A median gain of 10 years was judged necessary to make adjuvant HT worthwhile based on the hypothetical scenario of untreated mean survival time of 5 and 15 years. Median gain of 20% more women surviving was judged necessary to make adjuvant HT worthwhile based on an untreated 5-year survival rate expectation of 60%. Cognitive dysfunction was considered the side effect least compatible with the continuation of treatment in all three groups.

Conclusions

This is a large study of patient preferences on HT. Compared with other studies with similar design, the patients included in the present study required larger benefits to make adjuvant therapy worthwhile.

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Acknowledgements

We thank prof Fallowfield for the support in the plan of the study.

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Authors and Affiliations

  1. Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    E. Montagna, M. Colleoni, G. Cancello, E. Munzone, S. Dellapasqua, N. Bianco, G. Campennì, M. Iorfida, M. Mazza, A. De Maio, C. Sangalli & B. Scateni

  2. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy

    E. Pagan & V. Bagnardi

  3. Division of Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy

    P. Veronesi & V. Galimberti

  4. Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy

    G. Pettini, G. Pravettoni & K. Mazzocco

  5. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy

    G. Pravettoni & K. Mazzocco

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  1. E. Montagna
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Corresponding author

Correspondence to E. Montagna.

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Conflict of interest

E Montagna, G. Cancello and E. Munzone had consulting or Advisory Role from Pierre Fabre. M. Mazza received honoraria from Novartis, Pfizer, Istituto Gentili, Celgene, Astrazeneca. M. Colleoni received honoraria from Novartis and had consulting or Advisory Role from Pierre Fabre Pfizer OBI Pharma Puma Biotechnology Celldex AstraZeneca. The other authors declared no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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This article does not contain any studies with animals performed by any of the authors.

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Montagna, E., Pagan, E., Bagnardi, V. et al. Evaluation of endocrine therapy and patients preferences in early breast cancer: results of Elena study. Breast Cancer Res Treat 184, 783–795 (2020). https://doi.org/10.1007/s10549-020-05900-2

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  • DOI: https://doi.org/10.1007/s10549-020-05900-2

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