Patients' preferences for adjuvant chemotherapy in early breast cancer: what makes AC and CMF worthwhile now?

Duric, V.; Stockler, Martin R.; Héritier, Stéphane; Boyle, F.; Beith, Jane; Sullivan, A.; Wilcken, Nicholas; Coates, Alan S.; Simes, R. J.

doi:10.1093/annonc/mdi370

Cited by 109 publications

(113 citation statements)

References 14 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: Discussionmentioning

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: 90%

“…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%

“…The statistical methods were based on those used in similar previous studies (Simes and Coates, 2001;Duric et al, 2005). Preference data were described with graphs of the proportions of women judging various benefits sufficient to make adjuvant endocrine therapy worthwhile.…”

Section: Methodsmentioning

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: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

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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Mental health, treatment preferences, advance care planning, location, and quality of death in advanced cancer patients with dependent children

Nilsson

Maciejewski

Zhang

et al. 2009

Cancer

131

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BACKGROUND:Clinicians observe that advanced cancer patients with dependent children agonize over the impact their death will have on their children. The objective of this study was to determine empirically whether advanced cancer patients with and without dependent children differ in treatment preferences, mental health, and end‐of‐life (EOL) outcomes.METHODS:Coping with Cancer is a National Cancer Institute/National Institute of Mental Health‐funded, multi‐institutional, prospective cohort study of 668 patients with advanced cancer. Patients with and without dependent children were compared on rates of psychiatric disorders, advance care planning (ACP), EOL care, quality of their last week of life, and location of death.RESULTS:In adjusted analyses, patients with advanced cancer who had dependent children were more likely to meet panic disorder criteria (adjusted odds ratio [AOR], 5.41; 95% confidence interval [95% CI], 2.13–13.69), more likely to be worried (mean difference in standard deviations [δ], 0.09; P = .006), and more likely to prefer aggressive treatment over palliative care (AOR, 1.77; 95% CI, 1.07–2.93). Patients with dependent children were less likely to engage in ACP (eg, do not resuscitate orders: AOR, 0.44; 95% CI, 0.26–0.75) and had a worse quality of life in the last week of life (δ, 0.15; P = .007). Among spousal caregivers, those with dependent children were more likely to meet criteria for major depressive disorder (AOR, 4.53; 95% CI, 1.47–14) and generalized anxiety disorder (AOR, 3.95; 95% CI, 1.29–12.16).CONCLUSIONS:Patients with dependent children were more anxious, were less likely to engage in ACP, and were more likely to have a worse quality of life in their last week of life. Advanced cancer patients and spousal caregivers with dependent children represent a particularly distressed group that warrants further clinical attention, research, and support. Cancer 2009. © 2009 American Cancer Society.

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Understanding health‐related quality of life in adult women with metastatic cancer who have dependent children

Park

Deal

Yopp

et al. 2018

Cancer

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Patients' preferences for adjuvant chemotherapy in early breast cancer: what makes AC and CMF worthwhile now?

Abstract: Preferences were highly variable, but the benefits judged sufficient to make adjuvant chemotherapy worthwhile were even smaller than those found in previous studies. Preferences were influenced by factors other than direct benefits and harms of chemotherapy.

Cited by 109 publications

References 14 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?

Mental health, treatment preferences, advance care planning, location, and quality of death in advanced cancer patients with dependent children

Understanding health‐related quality of life in adult women with metastatic cancer who have dependent children

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