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Br J Cancer. 2016 Oct 11;115(8):912-919. doi: 10.1038/bjc.2016.276. Epub 2016 Sep 6.

Persistence to 5-year hormonal breast cancer therapy: a French national population-based study.

Author information

1
INSERM, U1219, Univ. Bordeaux, Population Health Research Center, Pharmacoepidemiology and Population Impact of Drugs Team, F-33000 Bordeaux, France.
2
CIC Bordeaux CIC1401, F-33000 Bordeaux, France.
3
CHU de Bordeaux, Department of Medical Pharmacology, F-33000 Bordeaux, France.

Abstract

BACKGROUND:

Non-persistence to oral hormonal therapy (HT) in breast cancer (BC) is an emerging health issue, and estimations vary according to the population selected and/or the statistical method applied. This study aimed to estimate non-persistence over 5 years to HT in an unselected sample of women with BC using a French national population-based database and accounting for competing risks.

METHODS:

A retrospective cohort of 600 women initiating a HT between 2006 and 2007 was constituted using a representative sample of the French national healthcare insurance system database. The Cumulative Incidence Function method was used to estimate the probability of first treatment discontinuation of at least 90 days accounting for competing risk of death from any cause over the theoretical 5-year period of treatment.

RESULTS:

Thirty one percent of patients who initiated a HT were identified as non-persistent at the fifth year of follow-up. Patients who switched to another HT (HR 3.10, 95% CI (2.20; 4.36)) or had metastatic BC (HR 3.07, 95% CI (1.73; 5.46)) were more likely to be non-persistent. Women who initiated aromatase inhibitors as compared with tamoxifen (HR 0.62, 95% CI (0.46; 0.83)), had administrative registration for BC (HR 0.21, 95% CI (0.13; 0.32)), or had received an adjuvant chemotherapy (HR 0.65, 95% CI (0.48; 0.89)) were less likely to discontinue.

CONCLUSIONS:

The estimate of long-term non-persistence in an unselected sample of women treated in France by oral hormonal therapy is substantial, even accounting for competing risks.

PMID:
27599040
PMCID:
PMC5061907
DOI:
10.1038/bjc.2016.276
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Pauline Bosco-Lévy, Dr A Fourrier-Réglat and Dr J Bezin have nothing to disclose. J Jové, P Robinson and Professor N Moore report that the Pharmacoepidemiology unit has received research funding and grants that have contributed indiscriminately to the salaries of its employees, notably from: Abott, Aptalis, AstraZeneca, Bayer, Baxter, BMS, Boehringer, Erempharma, Helsinn, Leo pharma, Lilly, Lunbeck, Pierre Fabre, Pfizer, Merck Serono, Novartis, Nycomed, Sanofi, Stallergenes, Vifor, Vivatech, from null, outside the submitted work.

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