目的:内分泌治疗引起的血管舒缩症状在乳腺癌幸存者中很常见,也是治疗中断和生活质量降低的危险因素。REALISE研究评估了接受内分泌治疗有血管舒缩症状的乳腺癌幸存者的真实世界治疗情况,包括药品,生活方式的改变,和非处方药。
方法:Adelphi血管舒缩疾病特定计划™的二次分析,在美国和五个欧洲国家(2020年2月至10月)进行的大型横截面时间点调查和图表审查。肿瘤学家提供了人口统计信息,临床,和接受内分泌治疗(他莫昔芬或芳香化酶抑制剂)的诱导血管舒缩症状的成年乳腺癌幸存者的治疗数据;患者自愿完成症状严重程度的自我报告调查,伴随的睡眠和/或情绪症状,生活方式的改变,和使用非处方产品。
方法:患者特征;血管舒缩症状严重程度;药物使用,生活方式的改变,和非处方产品(来自预定义的列表);处理线。
结果:总体而言,77名肿瘤学家报告了618名乳腺癌幸存者的数据,其中183人(29.6%)填写了自我报告表格。医师将420名(68.0%)女性归类为经历中重度血管舒缩症状,其中66.9%正在接受治疗。总的来说,所有乳腺癌幸存者中有15.2%接受了全身激素治疗。文拉法辛(24.7%),西酞普兰(16.5%),帕罗西汀(13.6%)是最常用的非激素药物.生活方式改变(77.8%)和非处方产品(61.6%)较为常见,尤其是伴随睡眠和/或情绪症状的患者。
结论:尽管有禁忌症,在有血管舒缩症状的寻求治疗的乳腺癌幸存者中,接受了全身激素治疗的比例相对较大.这个,加上患者报告的大量使用生活方式改变和非处方产品,提示在该人群中需要症状缓解,并且需要具有既定安全性的新的非激素替代品.
OBJECTIVE: Vasomotor symptoms induced by endocrine therapy are common in breast cancer survivors and a risk factor for therapy discontinuation and lower quality of life. The REALISE study evaluated the real-world treatment landscape in breast cancer survivors with vasomotor symptoms taking endocrine therapy, including pharmaceuticals, lifestyle changes, and over-the-counter products.
METHODS: Secondary analysis of the Adelphi Vasomotor Disease Specific Programme™, a large cross-sectional point-in-time survey and chart review conducted in the US and five European countries (February-October 2020). Oncologists provided demographic, clinical, and treatment data for adult breast cancer survivors with induced vasomotor symptoms taking endocrine therapy (tamoxifen or aromatase inhibitors); patients voluntarily completed self-report surveys on their symptom severity, concomitant sleep and/or mood symptoms, lifestyle changes, and use of over-the-counter products.
METHODS: Patient characteristics; vasomotor symptom severity; use of pharmaceuticals, lifestyle changes, and over-the-counter products (from pre-defined lists); lines of treatment.
RESULTS: Overall, 77 oncologists reported data for 618 breast cancer survivors, of whom 183 (29.6 %) completed self-report forms. Physicians classified 420 (68.0 %) women as experiencing moderate-severe vasomotor symptoms, of whom 66.9 % were receiving treatment. In total, 15.2 % of all breast cancer survivors were prescribed systemic hormone therapy. Venlafaxine (24.7 %), citalopram (16.5 %), and paroxetine (13.6 %) were the most commonly prescribed nonhormonal medications. Lifestyle changes (77.8 %) and over-the-counter products (61.6 %) were common, especially in patients with concomitant sleep and/or mood symptoms.
CONCLUSIONS: Despite contraindications, a relatively large proportion of treatment-seeking breast cancer survivors with vasomotor symptoms were prescribed systemic hormone therapy. This, combined with high patient-reported use of lifestyle changes and over-the-counter products, suggests a need for symptomatic relief and demand for new nonhormonal alternatives with established safety profiles in this population.