This study addresses a major problem for breast cancer patients that is often over-looked and generates ideas for future studies to better understand the patient experience.
Mary D. Chamberlin, MDPoor adherence to medication, or stopping medication earlier than recommended, is a big problem for 30–40% of people diagnosed with breast cancer. Poor adherence is due to many different factors such as hot flashes, night sweats or joint pain and is a risk factor for disease recurrence and lower survival.
New preliminary data from the highest accruing clinical trial at Dartmouth Cancer Center shows promise in improving poor adherence. In its first year, the NAOMI trial, led by clinician-researcher Mary D. Chamberlin, MD, is finding that people with breast cancer have better adherence when their medication is started before surgery. Fewer side effects may increase the likelihood that patients will adhere to recommendations and stay on their medications. Prospective data is in process but shows a trend toward improved early adherence (less than 12 months from diagnosis) compared to historical data (82% compared to 64%).
“This study addresses a major problem for breast cancer patients that is often over-looked and generates ideas for future studies to better understand the patient experience,” says Chamberlin, who presented these results at the San Antonio Breast Cancer Symposium in December 2023 with co-investigators Steven Tau, MD/PhD student at the Geisel School of Medicine at Dartmouth and Anne Christine Buteau, MD. “Further research is needed to determine if starting this medication before surgery actually decreases side effects or if other factors related to adherence are involved, but regardless, this study could change the standard of care of early-stage breast cancer if it improves adherence in the long term,” says Chamberlin.
Chamberlin’s team will likely complete trial enrollment in the next 6 months. The first 3-year mark for the first enrolled patient will be in December of 2025. There are two primary objectives, one of which is a short-term primary endpoint on molecular changes in the pre-operative period. “We will be publishing results of that endpoint in the next year to help fuel future patient-friendly translational research trials,” says Chamberlin. The final publication on adherence will be in the next several years.
Research that is patient-centered, such as the NAOMI trial, helps people with common challenges during their breast cancer experience and creates windows for important biomarker research for translational scientists to improve treatments.