Scholarlink

Background <p>Clinical trial data support the omission of radiation therapy (RT) in older women with early-stage breast cancer. The majority of older women still receive RT largely due to a lack of insight regarding endocrine therapy (ET) tolerance. The POWER trial is a phase II trial designed to determine whether 90 days of preoperative ET (pre-ET) changes patient or surgeon preferences for RT.</p> Methods <p>Between 2020 and 2024, two centers enrolled women aged 65 years or older with invasive carcinoma measuring ≤2&#xa0;cm, N0, and ER+/PR±/HER2−. All participants were recommended for 90 days of pre-ET. Patient and surgeon preferences for RT were evaluated before and after pre-ET. A change in preference was tested from an assumed low change rate of 5% to a rate of ≥15%, with a one-sided 5% level binomial test.</p> Results <p>Seventy-five women enrolled. Adverse events attributed to pre-ET occurred in 35 participants (47%). After pre-ET, 21 (28.0%) patients changed RT preference and surgeons changed RT recommendation for 18 (24.0%) patients (<i>p</i>&#xa0;&lt;&#xa0;0.001 and <i>p</i>&#xa0;=&#xa0;0.015, respectively). General agreement between patient and surgeon preferences before pre-ET was 53% (Kappa&#xa0;=&#xa0;−0.04) and increased to 81% (Kappa&#xa0;=&#xa0;0.59) after pre-ET.</p> Conclusion <p>Pre-ET significantly changed patient and surgeon preferences for RT and increased patient and surgeon agreement. The intentional resequencing of treatments enables patients to assess tolerance to ET before deciding whether to omit RT. This study validates pre-ET as an innovative method to inform adjuvant therapy decisions and recommendations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Ninety Days of Preoperative Endocrine Therapy Informs Patient and Physician Preference for Radiation Therapy: Primary Results from the Preoperative Window of Endocrine Therapy to Inform Radiation Therapy Decisions (POWER) Trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月2日

查看全文
  • Trish Millard,
  • Lena M. Turkheimer,
  • Gina Petroni,
  • David Brighton,
  • Max O. Meneveau,
  • Prisca Obidike,
  • Kandace McGuire,
  • Shayna L. Showalter

摘要

Background

Clinical trial data support the omission of radiation therapy (RT) in older women with early-stage breast cancer. The majority of older women still receive RT largely due to a lack of insight regarding endocrine therapy (ET) tolerance. The POWER trial is a phase II trial designed to determine whether 90 days of preoperative ET (pre-ET) changes patient or surgeon preferences for RT.

Methods

Between 2020 and 2024, two centers enrolled women aged 65 years or older with invasive carcinoma measuring ≤2 cm, N0, and ER+/PR±/HER2−. All participants were recommended for 90 days of pre-ET. Patient and surgeon preferences for RT were evaluated before and after pre-ET. A change in preference was tested from an assumed low change rate of 5% to a rate of ≥15%, with a one-sided 5% level binomial test.

Results

Seventy-five women enrolled. Adverse events attributed to pre-ET occurred in 35 participants (47%). After pre-ET, 21 (28.0%) patients changed RT preference and surgeons changed RT recommendation for 18 (24.0%) patients (p < 0.001 and p = 0.015, respectively). General agreement between patient and surgeon preferences before pre-ET was 53% (Kappa = −0.04) and increased to 81% (Kappa = 0.59) after pre-ET.

Conclusion

Pre-ET significantly changed patient and surgeon preferences for RT and increased patient and surgeon agreement. The intentional resequencing of treatments enables patients to assess tolerance to ET before deciding whether to omit RT. This study validates pre-ET as an innovative method to inform adjuvant therapy decisions and recommendations.