Effect of adjuvant endocrine therapy: single-agent vs. switching on breast cancer-free and overall survival - a retrospective cohort study
Abstract
Background: Patients with hormone-dependent breast cancer (HDBC) are prescribed adjuvant endocrine therapy (AET) in the form of tamoxifen or aromatase inhibitors (AI), either as single-agent endocrine therapy (SAET) or with a switch between them. However, the decision to maintain either strategy remains controversial. We aimed to compare breast cancer-free survival (BCFS) and overall survival (OS) in Mexican patients with HDBC under AET, be it as SAET or switching mode.
Materials and methods: We retrospectively analyzed a cohort of 300 patients diagnosed between 2009 and 2014. The association of BCFS and OS with clinical variables was analyzed with Cox and binary logistic regression models.
Results: In the univariate Cox models, compared to AI-based SAET, only tamoxifen-based SAET [hazard ratio (HR): 1.93, 95% confidence interval (CI): 1.13-3.3] exhibited association with BCFS; this became non-significant in the multivariate model. In the multivariate logistic models, compared to AI-based SAET, both tamoxifen-based SAET [odds ratio (OR): 2.2, 95% CI: 1.2-4.2] and switching (OR: 2.8, 95% CI: 1.3--.9) schemes were associated with recurrence or death events. Additionally, patients with an AET duration longer than 36 (OR: 0.18, 95% CI: 0.06-0.54) and 60 (OR: 0.26, 95% CI: 0.09-0.75) months had 82% and 74% lower odds of experiencing recurrence/death, respectively.
Conclusions: The data revealed discrepancies between the logistic and Cox regression models regarding the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 300 participants or records.
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