Evidence map›Paper›PMID 34918484›Full record

ArticleCancer medicine2022

Simulation modeling of breast cancer endocrine therapy duration by patient and tumor characteristics.

Young Chandler, Clyde Schechter, Jinani Jayasekera, Claudine Isaacs, Allison W Kurian, Christopher Cadham, Jeanne Mandelblatt

Open access · goldAbstract read
In one paragraph

Article in Cancer medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

7 authors at 3 institutions in 1 country.

Young ChandlerDepartment of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Clyde SchechterAlbert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Jinani JayasekeraDepartment of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Claudine IsaacsDepartment of Medicine, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Allison W KurianDepartments of Medicine and Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
Christopher CadhamDepartment of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Jeanne MandelblattDepartment of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA.ORCID 0000-0002-2490-005X
Georgetown University · USAlbert Einstein College of Medicine · USStanford Health Care · US

Funding

Comparative Modeling of Precision Breast Cancer Control Across the Translational Continuum - SupplementU01CA253911 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI ALAGOZ, OGUZHAN, DE KONING, HARRY J · 2020 to 2025
$10.6M
Comparative Modeling: Informing Breast Cancer Control Practice and PolicyU01CA199218 · NCI · GEORGETOWN UNIVERSITY · PI BERRY, DONALD A, DE KONING, HARRY J · 2015 to 2019
$9.0M
Bio-behavioral Research At The Intersection of Cancer and AgingR35CA197289 · NCI · GEORGETOWN UNIVERSITY · PI MANDELBLATT, JEANNE · 2015 to 2021
$6.2M
A Simulation Model-based Framework to Support Oncology Guidelines and PracticeK99CA241397 · NCI · GEORGETOWN UNIVERSITY · PI JAYASEKERA, JINANI · 2020 to 2021
$351k
Simulation Modeling to Assess Personalized Benefits and Harms of Extended Endocrine TherapyR03CA230952 · NCI · GEORGETOWN UNIVERSITY · PI CHANDLER, YOUNG · 2019 to 2020
$156k
NCI NIH HHS K99CA24139NCI NIH HHS K99 CA241397NCI NIH HHS R03 CA230952NCI NIH HHS R35 CA197289NCI NIH HHS R35CA197289NCI NIH HHS RO3CA230952NCI NIH HHS U01 CA199218NCI NIH HHS U01CA199218NCI NIH HHS U01 CA253911NCI NIH HHS U01CA253911
6 · The paper itself

Abstract

backgroundExtending endocrine therapy from 5 to 10 years is recommended for women with invasive estrogen receptor (ER)-positive breast cancers. We evaluated the benefits and harms of the five additional years of therapy.

methodsAn established Cancer Intervention and Surveillance Network (CISNET) model used a lifetime horizon with national and clinical trial data on treatment efficacy and adverse events and other-cause mortality among multiple birth cohorts of U.S. women ages 25-79 newly diagnosed with ER+, non-metastatic breast cancer. We assumed 100% use of therapy. Outcomes included life years (LYs), quality-adjusted life years (QALYs), and breast cancer mortality. Results were discounted at 3%. Sensitivity analyses tested a 15-year time horizon and alternative assumptions.

resultsExtending tamoxifen therapy duration among women ages 25-49 reduced the lifetime probability of breast cancer death from 11.9% to 9.3% (absolute difference 2.6%). This translates to a gain of 0.77 LYs (281 days)/woman (undiscounted). Adverse events reduce this gain to 0.44 QALYs and after discounting, gains are 0.20 QALYs (73 days)/woman. Extended aromatase inhibitor therapy in women 50-79 had small absolute benefits and gains were offset by adverse events (loss of 0.06 discounted QALYs). There were greater gains with extended endocrine therapy for women with node-positive versus negative cancers, but only women ages 25-49 and 50-59 had a net QALY gain. All gains were reduced with less than 100% treatment completion.

conclusionThe extension of endocrine therapy from 5 to 10 years modestly improved lifetime breast cancer outcomes, but in some women, treatment-related adverse events may outweigh benefits.

Indexed as

AdultAgedAge FactorsAntineoplastic Agents, HormonalAromatase InhibitorsBreast NeoplasmsComputer SimulationDuration of TherapyFemaleHumansMiddle AgedQuality-Adjusted Life YearsReceptors, EstrogenTamoxifenTreatment OutcomeUnited StatesAntineoplastic Agents, HormonalAromatase InhibitorsReceptors, EstrogenTamoxifenadjuvant therapyadverse eventsbreast cancerendocrine therapysimulation modeling

Identifiers

PMID34918484
PMCPMC8729060
OpenAlexW4200624940

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.