Evidence map›Paper›PMID 32920742›Full record

ArticleBreast cancer research and treatment2020

Predicting adjuvant endocrine therapy initiation and adherence among older women with early-stage breast cancer.

Max O Meneveau, Jessica Keim-Malpass, T Fabian Camacho, Roger T Anderson, Shayna L Showalter

Open access · greenAbstract read
In one paragraph

Article in Breast cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Max O MeneveauDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.ORCID http://orcid.org/0000-0002-8410-061X
Jessica Keim-MalpassUniversity of Virginia School of Nursing, Charlottesville, VA, USA.
T Fabian CamachoDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
Roger T AndersonDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
Shayna L ShowalterDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA. SNL2T@hscmail.mcc.virginia.edu.
University of Virginia · USCancer Research Center · US

Funding

Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
NCI NIH HHS T32 CA163177NIH HHS 5T32CA163177-09
6 · The paper itself

Abstract

purposeThe CALGB 9343 trial demonstrated that women age 70 or older with early-stage, estrogen receptor positive (ER +) breast cancer (BC) may safely forgo radiation therapy (RT) and be treated with breast conserving surgery followed by adjuvant endocrine therapy (AET) alone. However, most patients in this population still undergo RT in part because AET adherence is low. We sought to develop a predictive model for AET initiation and adherence in order to improve decision-making with respect to RT omission.

methodsWomen ages 70 and older with early-stage, ER + BC were identified using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Comorbidities, socioeconomic measures, prescription medications, and demographics were collected as potential predictors. Bivariate analysis was performed to identify factors associated with AET initiation and adherence. Stepwise selection of significant predictors was used to develop logistic regression classifiers for initiation and adherence. Model performance was evaluated using the c-statistic and other measures.

results11,037 patients met inclusion criteria. Within the cohort, 8703 (78.9%) patients initiated AET and 6685 (60.6%) were adherent to AET over 1 year. Bivariate predictors of AET initiation were similar to predictors of adherence. The best AET initiation and adherence classifiers were poorly predictive with c-statistics of 0.65 and 0.60, respectively.

conclusionsThe best models in the present study were poorly predictive, demonstrating that the reasons for initiation and adherence to AET are complex and individual to the patient, and therefore difficult to predict. Initiation and adherence to AET are important factors in decision-making regarding whether or not to forgo adjuvant RT. In order to better formulate treatment plans for this population, future work should focus on improving individual prediction of AET initiation and adherence.

Indexed as

Breast NeoplasmsAgedAntineoplastic Agents, HormonalChemotherapy, AdjuvantFemaleHumansMedicareMedication AdherenceUnited StatesAntineoplastic Agents, HormonalAdjuvant endocrine therapyBreast cancerCALGB 9343Medication adherenceRadiation

Identifiers

PMID32920742
PMCPMC8651151
OpenAlexW3086844814

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.