Dawn L. Hershman, MD

Dawn Hershman, MD, Associate Professor Medicine at Columbia University Medical Center, discusses the late-effects of intermittent androgen deprivation therapy (ADT) comapred to continuous ADT in prostate cancer.

The study looked at multiple late effects across both groups, including ischemic and thrombotic events, bone fractures, diabetes, obesity, depression, dementia, and sexual dysfunction.

There was a statistically significant higher rate of ischemic and thrombotic late effects among patients who had received intermittent ADT compared to continuous ADT. Other types of late effects were for the most part similar across the two groups, says Hershman.

These findings suggest more research is needed on the late effects of intermittent ADM before it should be commonly utilized, says Hershman.

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Dawn Hershman, MD, Associate Professor Medicine at Columbia University Medical Center, discusses the late-effects of intermittent androgen deprivation therapy (ADT) to continuous ADT in prostate cancer.

Dr. Hershman on Late Effects of Intermittent ADT for Prostate Cancer Patients 

Dawn L. Hershman, MD, MS, Associate Professor of Medicine and Epidemiology, Leader, Breast Cancer Program, Herbert Irving Comprehensive Cancer Center, Columbia University, describes the HOPE study, which looked at the effect of exercise versus usual care on aromatase inhibitor-associated arthralgias (joint pain) in women with breast cancer.

A main reason women have low quality of life on hormonal therapy or discontinue their therapy is because of side effects, Hershman says. Numerous studies have shown that the most common side effect of treatment with an aromatase inhibitor is joint discomfort. There are no therapies that have been proven to relieve this discomfort.

As exercise has been shown to improve symptoms in areas outside of cancer, it was hypothesized that it could help in this area. The HOPE study tested this hypothesis and found a 30% reduction in joint symptoms in patients randomized to exercise intervention. This reduction persisted over the course of one year and a dose response was also observed.

Dawn L. Hershman, MD, MS, describes the HOPE study, which looked at the effect of exercise versus usual care on aromatase inhibitor-associated arthralgias (joint pain) in women with breast cancer.

Dr. Hershman on Exercise and AI-Associated Arthralgias

Dawn L. Hershman, MD, MS, Associate Professor of Medicine and Epidemiology, Leader, Breast Cancer Program, Herbert Irving Comprehensive Cancer Center, Columbia University, discusses the need for adherence with longer hormonal therapy.

Recent studies have further verified the benefit for patients with breast cancer to stay on tamoxifen for 10 years as opposed to 5 years. As a result, the oncology community needs to consider issues related to adherence and compliance.

Researchers have found that at the end of 5 years of tamoxifen, only about 50% of patients take the medication greater than 80% of the time. Researchers also saw that about 25-30% of patients discontinued medication completely, while 25% took it intermittently.

These patients are so far out from their diagnosis, Hershman says, so physicians need to think about how to keep these patients engaged in treatment.

Dr. Hershman on Adherence to Longer Hormonal Therapy

Dawn L. Hershman, MD, MS, Associate Professor of Medicine and Epidemiology, Leader, Breast Cancer Program, Herbert Irving Comprehensive Cancer Center, Columbia University, discusses the use of compendia-approved oncology drugs.

Last year, Hershman says, the American Society of Clinical Oncology (ASCO) identified five areas where oncologists should focus on improving care. ASCO noted that oncologists should refrain from using medications and chemotherapies with no evidence of benefit.

The study that Hershman presented at the 2013 ASCO Meeting looked at patients with a variety of cancers over 65 years old using the SEER-Medicare Linked Database over a 10-year period. Researchers found that about 455 of patients received a drug not approved by the FDA. Of those patients, Hershman noted, a large proportion received drugs that were compendia-approved.

View more from the 2013 ASCO Annual Meeting

Dawn L. Hershman, MD, MS, discusses improving care and the use of compendia-approved oncology drugs.

Author | Dawn L. Hershman, MD

Articles

Dr. Hershman on Late Effects of Intermittent ADT for Prostate Cancer Patients

Dr. Hershman on Exercise and AI-Associated Arthralgias

Dr. Hershman on Adherence to Longer Hormonal Therapy

Dr. Hershman on the Use of Compendia-Approved Drugs