Concurrent new drug prescriptions and prognosis of early breast cancer

studies using the Danish Breast Cancer Group clinical database

Deirdre Cronin-Fenton, Timothy L Lash, Thomas P Ahern, Per Damkier, Peer Christiansen, Bent Ejlertsen, Henrik T Sørensen

Publikation: Bidrag til tidsskriftKonferenceartikelForskningpeer review

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Resumé

BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health.

METHODS: The Danish Breast Cancer Group (DBCG) clinical database provides high-quality prospectively collected data on breast cancer diagnosis, treatment, and routine follow-up for breast cancer recurrence. Individual-level linkage of DBCG data to other population-based and medical registries in Denmark, including the Danish National Prescription Registry, has facilitated large population-based pharmacoepidemiology studies. A unique advantage of using DBCG data for such studies is the ability to investigate the association of drugs with breast cancer recurrence rather than breast cancer mortality - which may be misclassified - or all-cause mortality. Here we summarize findings from pharmacoepidemiological studies, based on DBCG data, on the association between routinely used prescription drugs and risk of breast cancer recurrence.

RESULTS: Our findings suggest that concurrent use of glucocorticoids, ACE inhibitors, aspirin, NSAIDs, selective COX-2 inhibitors, digoxin, and opioids has little impact on breast cancer recurrence. Similarly, patients who use SSRIs concurrently with tamoxifen treatment are not at increased risk of recurrence. In contrast, post-diagnostic use of simvastatin, a lipophilic statin, correlates with a decreased risk of breast cancer recurrence, providing a rationale for a prospective randomized clinical trial investigating simvastatin as an adjuvant therapy for breast cancer.

CONCLUSION: As a whole, findings of pharmacoepidemiological studies based on DBCG data provide reassurance to physicians and healthcare personnel who provide supportive care during and after cancer (including prescriptions for comedications) and to breast cancer survivors for whom the risk of breast cancer recurrence is a major concern.

OriginalsprogEngelsk
TidsskriftActa Oncologica
Vol/bind57
Udgave nummer1
Sider (fra-til)120-128
ISSN0284-186X
DOI
StatusUdgivet - jan. 2018
Begivenhed16th Acta Oncologica Symposium - Aarhus , Danmark
Varighed: 18. jan. 201819. jan. 2018

Konference

Konference16th Acta Oncologica Symposium
LandDanmark
ByAarhus
Periode18/01/201819/01/2018

Fingeraftryk

Databases
Simvastatin
Prescriptions
Registries
Pharmacoepidemiology
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cyclooxygenase 2 Inhibitors
Denmark
Pharmaceutical Preparations
Glucocorticoids
Population
Survivors
Randomized Controlled Trials
Public Health
Delivery of Health Care
Physicians

Citer dette

Cronin-Fenton, Deirdre ; Lash, Timothy L ; Ahern, Thomas P ; Damkier, Per ; Christiansen, Peer ; Ejlertsen, Bent ; Sørensen, Henrik T. / Concurrent new drug prescriptions and prognosis of early breast cancer : studies using the Danish Breast Cancer Group clinical database. I: Acta Oncologica. 2018 ; Bind 57, Nr. 1. s. 120-128.
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Concurrent new drug prescriptions and prognosis of early breast cancer : studies using the Danish Breast Cancer Group clinical database. / Cronin-Fenton, Deirdre; Lash, Timothy L; Ahern, Thomas P; Damkier, Per; Christiansen, Peer; Ejlertsen, Bent; Sørensen, Henrik T.

I: Acta Oncologica, Bind 57, Nr. 1, 01.2018, s. 120-128.

Publikation: Bidrag til tidsskriftKonferenceartikelForskningpeer review

TY - GEN

T1 - Concurrent new drug prescriptions and prognosis of early breast cancer

T2 - studies using the Danish Breast Cancer Group clinical database

AU - Cronin-Fenton, Deirdre

AU - Lash, Timothy L

AU - Ahern, Thomas P

AU - Damkier, Per

AU - Christiansen, Peer

AU - Ejlertsen, Bent

AU - Sørensen, Henrik T

PY - 2018/1

Y1 - 2018/1

N2 - BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health.METHODS: The Danish Breast Cancer Group (DBCG) clinical database provides high-quality prospectively collected data on breast cancer diagnosis, treatment, and routine follow-up for breast cancer recurrence. Individual-level linkage of DBCG data to other population-based and medical registries in Denmark, including the Danish National Prescription Registry, has facilitated large population-based pharmacoepidemiology studies. A unique advantage of using DBCG data for such studies is the ability to investigate the association of drugs with breast cancer recurrence rather than breast cancer mortality - which may be misclassified - or all-cause mortality. Here we summarize findings from pharmacoepidemiological studies, based on DBCG data, on the association between routinely used prescription drugs and risk of breast cancer recurrence.RESULTS: Our findings suggest that concurrent use of glucocorticoids, ACE inhibitors, aspirin, NSAIDs, selective COX-2 inhibitors, digoxin, and opioids has little impact on breast cancer recurrence. Similarly, patients who use SSRIs concurrently with tamoxifen treatment are not at increased risk of recurrence. In contrast, post-diagnostic use of simvastatin, a lipophilic statin, correlates with a decreased risk of breast cancer recurrence, providing a rationale for a prospective randomized clinical trial investigating simvastatin as an adjuvant therapy for breast cancer.CONCLUSION: As a whole, findings of pharmacoepidemiological studies based on DBCG data provide reassurance to physicians and healthcare personnel who provide supportive care during and after cancer (including prescriptions for comedications) and to breast cancer survivors for whom the risk of breast cancer recurrence is a major concern.

AB - BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health.METHODS: The Danish Breast Cancer Group (DBCG) clinical database provides high-quality prospectively collected data on breast cancer diagnosis, treatment, and routine follow-up for breast cancer recurrence. Individual-level linkage of DBCG data to other population-based and medical registries in Denmark, including the Danish National Prescription Registry, has facilitated large population-based pharmacoepidemiology studies. A unique advantage of using DBCG data for such studies is the ability to investigate the association of drugs with breast cancer recurrence rather than breast cancer mortality - which may be misclassified - or all-cause mortality. Here we summarize findings from pharmacoepidemiological studies, based on DBCG data, on the association between routinely used prescription drugs and risk of breast cancer recurrence.RESULTS: Our findings suggest that concurrent use of glucocorticoids, ACE inhibitors, aspirin, NSAIDs, selective COX-2 inhibitors, digoxin, and opioids has little impact on breast cancer recurrence. Similarly, patients who use SSRIs concurrently with tamoxifen treatment are not at increased risk of recurrence. In contrast, post-diagnostic use of simvastatin, a lipophilic statin, correlates with a decreased risk of breast cancer recurrence, providing a rationale for a prospective randomized clinical trial investigating simvastatin as an adjuvant therapy for breast cancer.CONCLUSION: As a whole, findings of pharmacoepidemiological studies based on DBCG data provide reassurance to physicians and healthcare personnel who provide supportive care during and after cancer (including prescriptions for comedications) and to breast cancer survivors for whom the risk of breast cancer recurrence is a major concern.

KW - Adrenergic beta-Antagonists/therapeutic use

KW - Analgesics, Opioid/therapeutic use

KW - Angiotensin-Converting Enzyme Inhibitors/therapeutic use

KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use

KW - Aspirin/therapeutic use

KW - Breast Neoplasms/pathology

KW - Cardiotonic Agents/therapeutic use

KW - Cyclooxygenase 2 Inhibitors/therapeutic use

KW - Databases, Factual

KW - Denmark

KW - Digoxin/therapeutic use

KW - Disease Progression

KW - Estrogen Antagonists/therapeutic use

KW - Female

KW - Glucocorticoids/therapeutic use

KW - Humans

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use

KW - Neoplasm Recurrence, Local

KW - Platelet Aggregation Inhibitors/therapeutic use

KW - Prognosis

KW - Serotonin Uptake Inhibitors/therapeutic use

KW - Simvastatin/therapeutic use

KW - Tamoxifen/therapeutic use

U2 - 10.1080/0284186X.2017.1407040

DO - 10.1080/0284186X.2017.1407040

M3 - Conference article

VL - 57

SP - 120

EP - 128

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 1

ER -