Bashar Zeidan
Royal Hampshire County Hospital, UK
Title: The impact of Nolvadex to generic tamoxifen switch on side effects and patient compliance in hormone receptor positive breast cancer patients
Biography
Biography: Bashar Zeidan
Abstract
Introduction: Adjuvant hormonal therapy in oestrogen receptor (ER) positive breast cancer patients improves survival. In 2006 the original tamoxifen preparation (Nolvadex) was discontinued and patients were since gradually switched to alternative generic tamoxifen brands. The goal of this study is to evaluate factors affecting adjuvant tamoxifen related side effects and compliance including altering tamoxifen products.
Methods: Consecutive patients treated for ER positive breast cancer (stage I-III) in the Royal Hampshire County Hospital between January 1, 2007 and December 31, 2009 were included. 327 questionnaires were sent to eligible patients. Pearson’s c2 test was used for data analysis.
Results: 59% of patients experienced side effects associated with tamoxifen treatment out of which 53% were severe. Switching to generic tamoxifen was associated with more severe side effects (p=0.02). Non-prescribed supplements were taken by 42% of symptomatic patients with no significant improvement (p=0.05). Interestingly, the concomitant use of SSRI had no effect on side effects experienced by patients. A significant number of patients considered discontinuing tamoxifen because of the side effects (p=0.001), yet this did not translate into tamoxifen discontinuation or non adherence (p=0.8 and 0.08 respectively).
Conclusions: Severe tamoxifen side effects are commonly experienced by breast cancer patients and are altered by change in tamoxifen brand. Most patients will continue to take tamoxifen despite these side effects following clinicians’ advice to avoid cancer relapse. Supplementation and antidepressants did not improve tamoxifen related side effects. Further studies are needed to validate our preliminary findings.