Kathy D. Miller, MD; Jennifer A. Ligibel, MD


December 23, 2013

In This Article

Aromatase Inhibitor Adherence

Dr. Miller: Another important endpoint that you might not have had a chance to look at yet is whether the women in the exercise group continue taking their aromatase inhibitor to a greater degree. That has been a huge problem with fall-off and adherence with therapy for many reasons, including the musculoskeletal toxicity.

Dr. Ligibel: Absolutely, and that is one of the things we will look at in this study. However, this is a somewhat select population in that respect. These women are already having joint pain from the aromatase inhibitor and were still taking them. They had to have been taking them for at least 6 months. In the initial screening from this study, Dr. Irwin found that a significant proportion of patients had already stopped taking the aromatase inhibitors because of joint pain. As the next step, we need to see whether people increase their exercise and whether that makes a difference in adherence, because often the joint pain starts pretty quickly after women initiate these drugs.

Many women stop taking them early on. Clearly, the main goal here is to show that we can help people continue these drugs. We are looking at studies that involve 10 years of therapy, but if the women can't get past the first few months because of joint pain, they are not going to be able to derive the benefits from the drug. We need to find ways to help make these drugs more tolerable to people over time.

Dr. Miller: While you look at these other analyses, what is the next study and where is the research group headed in this important area?

Dr. Ligibel: There is a lot of interest in learning more about the mechanisms and what is happening biologically with exercise that could affect arthralgias and other outcomes in breast cancer. We are also very interested in looking at some of the adherence questions, looking cross-sectionally to find out whether people who exercise are more likely to stick with their medications, and whether earlier exercise could help prevent women from dropping off the aromatase inhibitors in those early days of taking them.

Dr. Miller: Thank you, Jennifer. We will definitely stay tuned and work harder on getting our patients to work harder -- in some ways, at least. Thank you for joining us for this edition of Medscape Oncology Insights. This is Kathy Miller, reporting from the San Antonio Breast Cancer Symposium 2013.


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