title: Eligibility, compliance and persistence of sequential therapy with aromatase inhibitors following 2-3 years of tamoxifen in endocrine adjuvant breast cancer therapy.
abstract: OBJECTIVE
  This study evaluated the eligibility, compliance and persistence of sequential therapy, i.e. a switch to an aromatase inhibitor (AI) following 2-3 years of tamoxifen, in adjuvant endocrine breast cancer (BC) treatment.
  
  
  METHODS
  Data concerning 388 BC patients (age ≤70 years) who started endocrine adjuvant therapy between 1998 and 2008 were analyzed.
  
  
  RESULTS
  From the 263 patients who started therapy with tamoxifen, 167 (63.5%) were eligible for a sequential therapy. Fifty-nine patients (35.3%) were offered a switch by their physicians; women who had their follow-up at oncological units received the offer more often when compared to those treated by general practitioners (p < 0.001). Out of these 59 patients, 50 followed the proposal (compliance 84.7%). Of those who agreed to a sequential therapy, 2 (4%) were non-persistent to endocrine therapy; in 9 cases (18.0%), a re-switch to tamoxifen was done due to AI-related adverse side effects.
  
  
  CONCLUSIONS
  Only a minority of the patients who started an endocrine adjuvant BC therapy was eligible for sequential therapy. Patients who underwent a switch had a high rate of persistence. Efforts should be made to make sure that all physicians, above all general practitioners, who are involved in the treatment of BC patients, are provided with current therapy guidelines.
authors: Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland.
authors: Nerbil
authors: N
authors: Kilic
authors: Mary Elizabeth
authors: ME
authors: Myrick
authors: Seraina Margaretha
authors: SM
authors: Schmid
authors: Uwe
authors: U
authors: Gueth
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen