The impact of tamoxifen brand switch on side effects and patient compliance in hormone receptor positive breast cancer patients
The impact of tamoxifen brand switch on side effects and patient compliance in hormone receptor positive breast cancer patients
Background:
In 2006 Nolvadex was discontinued and replaced by a variety of alternative generic tamoxifen brands for the adjuvant treatment of breast cancer. Anecdotally, patients are switching brands and taking alternative medications to reduce treatment related symptoms. Nevertheless, more severe side effects may equate to better relapse prevention. This study evaluates generic tamoxifen adherence and its correlation with side effects and brand switch.
Methods:
Consecutive disease free ER positive patients (stage I–III) were invited to respond to a questionnaire. 165 of 327 questionnaires were returned (50% response). Pearson's Chi Square test was used for data analysis.
Results:
63 patients (38%) reported a switch between generic tamoxifen. 59% of all patients experienced side effects associated with tamoxifen treatment of which 53% were severe. Patients experiencing differential symptoms dependent on tamoxifen brand reported more severe side effects (p = 0.02). Non-prescribed supplements were taken by 42% of all patients with no significant improvement in climacteric symptoms (p = 0.05). The concomitant use of SSRIs appeared to have no effect on symptoms. A significant number of patients considered discontinuing tamoxifen because of the side effects (p = 0.001), yet this did not translate into discontinuation or non-adherence (p = 0.8 and 0.08 respectively).
Conclusion:
Severe tamoxifen side effects are commonly experienced by breast cancer patients and can be significantly altered by change in tamoxifen brand.
Most patients will continue to take tamoxifen, despite side effects to avoid cancer relapse. Supplementation and antidepressants did not improve tamoxifen related side effects in our cohort.
62-67
Zeidan, B.
acd18415-22ee-43b8-a102-a36ea22dd0af
Anderson, K.
ef4598bc-7bac-4a63-8d41-ec30d6cfd2b6
Pieris, L.
9c0c1bd4-3339-45f5-9cc4-be5859bcdaec
Rainsbury, D.
74858698-1f3f-48fa-bfce-c50369cb222b
Laws, S.
cc976018-6586-4c15-aff6-468f4e543fad
31 October 2016
Zeidan, B.
acd18415-22ee-43b8-a102-a36ea22dd0af
Anderson, K.
ef4598bc-7bac-4a63-8d41-ec30d6cfd2b6
Pieris, L.
9c0c1bd4-3339-45f5-9cc4-be5859bcdaec
Rainsbury, D.
74858698-1f3f-48fa-bfce-c50369cb222b
Laws, S.
cc976018-6586-4c15-aff6-468f4e543fad
Zeidan, B., Anderson, K., Pieris, L., Rainsbury, D. and Laws, S.
(2016)
The impact of tamoxifen brand switch on side effects and patient compliance in hormone receptor positive breast cancer patients.
The Breast, 29, .
(doi:10.1016/j.breast.2016.07.001).
Abstract
Background:
In 2006 Nolvadex was discontinued and replaced by a variety of alternative generic tamoxifen brands for the adjuvant treatment of breast cancer. Anecdotally, patients are switching brands and taking alternative medications to reduce treatment related symptoms. Nevertheless, more severe side effects may equate to better relapse prevention. This study evaluates generic tamoxifen adherence and its correlation with side effects and brand switch.
Methods:
Consecutive disease free ER positive patients (stage I–III) were invited to respond to a questionnaire. 165 of 327 questionnaires were returned (50% response). Pearson's Chi Square test was used for data analysis.
Results:
63 patients (38%) reported a switch between generic tamoxifen. 59% of all patients experienced side effects associated with tamoxifen treatment of which 53% were severe. Patients experiencing differential symptoms dependent on tamoxifen brand reported more severe side effects (p = 0.02). Non-prescribed supplements were taken by 42% of all patients with no significant improvement in climacteric symptoms (p = 0.05). The concomitant use of SSRIs appeared to have no effect on symptoms. A significant number of patients considered discontinuing tamoxifen because of the side effects (p = 0.001), yet this did not translate into discontinuation or non-adherence (p = 0.8 and 0.08 respectively).
Conclusion:
Severe tamoxifen side effects are commonly experienced by breast cancer patients and can be significantly altered by change in tamoxifen brand.
Most patients will continue to take tamoxifen, despite side effects to avoid cancer relapse. Supplementation and antidepressants did not improve tamoxifen related side effects in our cohort.
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More information
Accepted/In Press date: 2 July 2016
e-pub ahead of print date: 16 July 2016
Published date: 31 October 2016
Organisations:
Cancer Sciences
Identifiers
Local EPrints ID: 411036
URI: http://eprints.soton.ac.uk/id/eprint/411036
ISSN: 0960-9776
PURE UUID: 01165935-343b-4897-a34c-c86de42736f4
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Date deposited: 13 Jun 2017 16:32
Last modified: 15 Mar 2024 14:18
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Contributors
Author:
B. Zeidan
Author:
K. Anderson
Author:
L. Pieris
Author:
D. Rainsbury
Author:
S. Laws
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