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Purpose <p>Extended adjuvant endocrine therapy (AET) beyond 5&#xa0;years (up to 10&#xa0;years) has been shown to be beneficial for some women with non-metastatic, hormone-receptor positive breast cancer. Much of our current understanding of adherence to and continuation with AET is derived from examining the 5&#xa0;years after AET initiation and is limited beyond the first 5&#xa0;years. To address this limitation, we conducted a retrospective cohort study examining AET adherence and time of continuation beyond 5&#xa0;years among a large, real-world population in Northern California.</p> Methods <p>We evaluated adherence to and continuation of extended AET among a cohort of 13,675 women diagnosed with Stage I-III, estrogen receptor positive (ER+) breast cancer between 2008 and 2017 treated at Kaiser Permanente Northern California. Adherence (medication possession ratio &gt; 80%) and discontinuation (last pill possession date before a 180-day gap) of AET were examined.</p> Results <p>Annual AET adherence declined gradually each year from 79% in year 1–60% in year 5 and dropped dramatically to 23% in year 6. Following year 6, annual adherence again declined gradually and was 10% in year 10. Similarly, there was a striking decline in AET continuation between year 5 (52%) and year 6 (20%). Only 4.5% continued to the end of year 10.</p> Conclusions <p>We observed a dramatic drop in both adherence to and continuation with AET following year 5 into year 6. This potentially represents an inflection point for intervention to improve adherence to and continuation with extended AET among this patient population.</p>

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Beyond the 5-year mark: adherence to and continuation of extended adjuvant endocrine therapy in non-metastatic breast cancer patients

  • 期刊论文

  • 发表日期：

    2025年8月27日

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  • Jenny Wei,
  • Ashley Aller,
  • Shiyun Zhu,
  • Laurel A. Habel,
  • Catherine Lee,
  • Jun Shan,
  • Ninah Achacoso,
  • Aida Shirazi,
  • Marc A. Emerson,
  • Raymond Liu

摘要

Purpose

Extended adjuvant endocrine therapy (AET) beyond 5 years (up to 10 years) has been shown to be beneficial for some women with non-metastatic, hormone-receptor positive breast cancer. Much of our current understanding of adherence to and continuation with AET is derived from examining the 5 years after AET initiation and is limited beyond the first 5 years. To address this limitation, we conducted a retrospective cohort study examining AET adherence and time of continuation beyond 5 years among a large, real-world population in Northern California.

Methods

We evaluated adherence to and continuation of extended AET among a cohort of 13,675 women diagnosed with Stage I-III, estrogen receptor positive (ER+) breast cancer between 2008 and 2017 treated at Kaiser Permanente Northern California. Adherence (medication possession ratio > 80%) and discontinuation (last pill possession date before a 180-day gap) of AET were examined.

Results

Annual AET adherence declined gradually each year from 79% in year 1–60% in year 5 and dropped dramatically to 23% in year 6. Following year 6, annual adherence again declined gradually and was 10% in year 10. Similarly, there was a striking decline in AET continuation between year 5 (52%) and year 6 (20%). Only 4.5% continued to the end of year 10.

Conclusions

We observed a dramatic drop in both adherence to and continuation with AET following year 5 into year 6. This potentially represents an inflection point for intervention to improve adherence to and continuation with extended AET among this patient population.