Investigating How to Help Patients With Breast Cancer Stay on Therapy

Julie Gralow, MD, the clinical director of Breast Medical Oncology at the Seattle Cancer Care Alliance, professor of Medical Oncology at the University of Washington School of Medicine, and professor of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, discusses the use of patient-reported outcomes in the SWOG S1105 trial and different factors for patients with early-stage breast cancer on an aromatase inhibitor to see if they could predict who may be more likely to stop taking treatment early.

Gralow says she and the other investigators found that younger patients tended to be less adherent after 3 years and were not on the drug more often than older patients on the study. They also found that patients who had endocrine symptoms or pain, such as joint aches, before starting on therapy were less likely to continue therapy over all 3 years of the trial. Surveys about thoughts and beliefs on medication predicted which patients would discontinue as well.

The investigators found a group who are more adherent who may not need more help with adhering to their regimen, and physicians then can focus on the higher risk group to design interventions to help these patients stay on therapy, according to Gralow. In respect to using text messages to help patients, which was the initial study objective of the study, the investigators have come up with new ideas like making the messages more personalized to what patients reported at baseline or what patients are communicating in the moment. The investigators may try to give tips for how to manage issues, such as using acupuncture to combat joint aches that come with aromatase inhibitors. They also want to try having 2-way communication, so the patients can interact by sending back information and the physician can then tailor the help they are giving the patient.

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