Early breast cancer: text messages fail to avert early AI discontinuation

  • Hershman DL & al.
  • J Clin Oncol
  • 5 mai 2020

  • Par Miriam Davis, PhD
  • Résumés d'articles
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Takeaway

  • Biweekly text messaging (TM) vs no TM for 36 months yielded no improvement in time to adherence failure (AF) with aromatase inhibitor (AI) therapy in women with hormone receptor (HR)-positive early breast cancer.

Why this matters

  • Nonadherence to AI is common, with full adherence over a 5-year duration averaging only 50%.
  • Nonadherence heightens the risk of recurrence.

Study design

  • Randomized controlled trial (n=724) of TM vs no TM for a planned duration of ≥36 months.
  • TM content dealt with overcoming barriers to adherence and included cues to taking action.
  • Primary outcome: time to AF defined as urine AI metabolite assay satisfying any one of these outcomes:
  • Funding: NIH; Breast Cancer Research Foundation; others.

Key results

  • At 36 months, observed adherence did not differ between groups:
    • 55.4% TM vs 55.4% no TM.
  • Groups also did not differ in primary outcome, time to AF at 3 years:
    • 81.9% TM vs 85.6% no TM;
    • HR, 0.89 (P=.18).
  • No difference between groups in 3 years:
    • Self-reported time to AF:
      • 10.4% TM vs 10.3% no TM;
      • HR, 1.16 (P=.57). 
    • Site-reported time to AF:
      • 21.9% TM vs 18.9% no TM;
      • HR, 1.31 (P=.21).

Limitations

  • Unblinded.