But how much would it improve if patients knew the likelihood of BC recurrence if they did not follow their drug regimen?
That was the question addressed in a new study led by the University of Florida College of Pharmacy. The researchers measured BC recurrence in nonmetastatic survivors who were nonadherent to endocrine therapy (ET).
In an article in the British Journal of Cancer, the study team noted that during the first year of ET use, nearly 30% of BC survivors are nonadherent, which could increase BC recurrence risk. Their efforts were to examine the association between ET adherence trajectories and BC recurrence risk in nonmetastatic BC survivors.
The retrospective cohort study included Medicare beneficiaries in the United States with incident nonmetastatic BC followed by endocrine therapy initiation in 2010-2019 U.S. Surveillance, Epidemiology, and End Results (SSER)–linked Medicare data.
The researchers calculated monthly fill–based proportion of days covered in the first year of ET and then applied group-based trajectory models to identify distinct ET adherence patterns. After the end of the first-year endocrine therapy trajectory measurement period, the risk of time to first treated BC recurrence within 4 years was measured using Cox proportional hazards models.
The results identified five trajectories of adherence to endocrine therapy in BC stages 0-I subgroup, which involved 28,042 patients, and in stages II-III subgroup with 7,781 patients.
“A trajectory of discontinuation before 6 months accounted for 7.0% in Stages 0-I and 5.8% in Stages II-III subgroups, and this trajectory was associated with an increased treated BC recurrence risk compared to nearly perfect adherence (Stages 0-I: adjusted hazard [aHR] = 1.84, 95% CI = 1.46-2.33; Stages II-III: aHR = 1.38, 95% CI = 1.07-1.77),” the authors wrote.
They concluded that nearly 7% of BC survivors who discontinued before completing 6 months of treatment was associated with an increased treated BC recurrence risk compared with those with nearly perfect adherence among Medicare nonmetastatic BC survivors.
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