Patients' preferences for adjuvant chemotherapy in early breast cancer: a review of what makes it worthwhile?

Duric, V.; Stockler, Martin R.

doi:10.1016/s1470-2045(01)00559-9

Cited by 102 publications

(69 citation statements)

References 13 publications

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“…Studies of preferences for adjuvant chemotherapy in early breast cancer found that less severe side effects and having dependents were associated with smaller benefits being judged sufficient to make it worthwhile (Duric and Stockler, 2001;Duric et al, 2005). Severity of side effects was similarly associated with preferences in this study, but having dependents was not significantly associated with preferences in this study, perhaps because of the greater homogeneity of our sample and the small number of women without dependents.…”

Section: Discussioncontrasting

confidence: 45%

“…More than half the women who had adjuvant endocrine therapy as part of routine clinical practice judged 2% gain in survival rate or an additional 3 -6 months sufficient to make adjuvant endocrine therapy worthwhile (Thewes et al, 2005). Yet women in this study required larger benefits to make adjuvant endocrine worthwhile than those judged necessary to make chemotherapy worthwhile in comparable studies using almost identical methods (Duric and Stockler, 2001;Jansen et al, 2001;Duric et al, 2005) and larger still than those required by women who had endocrine therapy as part of routine clinical practice (Thewes et al, 2005).…”

Section: Discussionmentioning

confidence: 86%

“…This is surprising given the widespread perception by healthcare professionals that endocrine therapy has only modest toxicity. Women who have had adjuvant chemotherapy for early breast cancer judge small benefits sufficient to make it worthwhile, despite its significant side effects and inconvenience (Duric and Stockler, 2001;Jansen et al, 2001;Duric et al, 2005). Adjuvant endocrine therapy provides comparable benefits for women with hormone-receptor positive disease, and is generally considered to do so with less severe side effects and less inconvenience.…”

Section: Discussionmentioning

confidence: 99%

“…Measuring the preferences of patients who have had a treatment gives insights into how they trade-off the treatment's benefits and harms. Many women with early breast cancer judge small benefits sufficient to make adjuvant chemotherapy worthwhile despite its inconvenience and side effects (Duric and Stockler, 2001;Jansen et al, 2001;Duric et al, 2005). The benefits of adjuvant endocrine therapy in women with hormone-receptor positive breast cancer are comparable to those of adjuvant chemotherapy.…”

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confidence: 99%

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Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile?

et al. 2005

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Adjuvant endocrine therapy improves recurrence and survival rates, but has side effects and is inconvenient. The aim of this study was to determine the preferences of premenopausal women who had adjuvant endocrine therapy in a randomised trial. In all, 85 (or eighty-five) women completed semistructured interviews 6 -30 months after finishing adjuvant endocrine therapy. Hypothetical scenarios based on known potential survival times (5 or 15 years) and rates (60% or 80% at 5 years) without adjuvant endocrine therapy were used to determine the smallest gains women judged necessary to make their adjuvant endocrine therapy worthwhile. Although a third of the women considered gains of 1% in survival rates or 6 months in survival times sufficient to make their adjuvant endocrine therapy worthwhile, more than half the women required gains of at least 5% in survival rates or 3 years in survival time as necessary to make adjuvant endocrine therapy worthwhile. Larger benefits were required by women who had longer treatment, worse side effects, and by those who were treated with goserelin alone. The route of administration (tablet vs injection) did not affect preferences and some women judged small benefits sufficient to make their adjuvant endocrine therapy worthwhile, but many women required larger benefits than their counterparts in similar studies of preferences for adjuvant chemotherapy.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile?

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“…Most women who undergo adjuvant chemotherapy for early-stage breast cancer consider its benefits to be worthwhile, whereas only 1%-2% of patients would not repeat chemotherapy regardless of the magnitude of potential benefit [2].…”

mentioning

confidence: 99%

Doc, I Don't Want Your Poison

Giorgi¹,

Bascioni²

2012

The Oncologist

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Necessary and sufficient conditions for the asymmetric synthesis of chiral amines using ω‐aminotransferases

Seo

Kyung

Joo

et al. 2010

Biotech & Bioengineering

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The half reactions of ω-aminotransferase (ω-AT) from Vibrio fluvialis JS17 (ω-ATVf) were carried out using purified pyridoxal 5'-phosphate-enzyme (PLP-Enz) and pyridoxamine 5'-phosphate-enzyme (PMP-Enz) complexes to investigate the relative activities of substrates. In the reaction generating PMP-Enz from PLP-Enz using L-alanine as an amine donor, L-alanine showed about 70% of the initial reaction rate of (S)-α-methylbenzylamine ((S)-α-MBA). However, in the subsequent half reaction recycling PLP-Enz from PMP-Enz using acetophenone as an amine acceptor, acetophenone showed nearly negligible reactivity compared to pyruvate. These results indicate that the main bottleneck in the asymmetric synthesis of (S)-α-MBA lies not in the amination of PLP by alanine, but in the amination of acetophenone by PMP-Enz, where conformational restraints of the enzyme structure is likely to be the main reason for limiting the amine group transfer from PMP-Enz to acetophenone. Based upon those half reaction experiments using the two amino acceptors of different activity, it appears that the relative activities of the two amine donors and the two acceptors involved in the ω-AT reactions can roughly determine the asymmetric synthesis yield of the target chiral amine compound. Predicted conversion yields of several target chiral amines were calculated and compared with the experimental conversion yields. Approximately, a positive linear correlation (Pearson's correlation coefficient = 0.92) was observed between the calculated values and the experimental conversion yields. To overcome the low (S)-α-MBA productivity of ω-ATVf caused by the possible disadvantageous structural constraints for acetophenone, new ω-ATs showing higher affinity to benzene ring of acetophenone than ω-ATVf were computationally screened using comparative modeling and protein-ligand docking. ω-ATs from Streptomyces avermitilis MA-4680 (SAV2612) and Agrobacterium tumefaciens str. C58 (Atu4761) were selected, and the two screened ω-ATs showed higher asymmetric synthesis reaction rate of (S)-α-MBA and lower (S)-α-MBA degradation reaction rate than ω-ATVf. To verify the higher conversion yield of the variants of ω-ATs, the reaction with 50 mM acetophenone and 50 mM alanine was performed with coupling of lactate dehydrogenase and two-phase reaction system. SAV2612 and Atu4761 showed 70% and 59% enhanced yield in the synthesis of (S)-α-MBA compared to that of ω-ATVf, respectively.

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Patients' preferences for adjuvant chemotherapy in early breast cancer: a review of what makes it worthwhile?

Cited by 102 publications

References 13 publications

Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile?

Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile?

Doc, I Don't Want Your Poison

Necessary and sufficient conditions for the asymmetric synthesis of chiral amines using ω‐aminotransferases

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