Abstract 1818MO
Background
AIMT is common in pts with EBC on aromatase inhibitors (AI) and may lead to treatment discontinuation and detriment on clinical outcomes. We aimed to generate a predictive model of AIMT and to identify targets for early interventions.
Methods
We included postmenopausal pts with stage I-III BC treated with adjuvant AI from CANTO (NCT01993498). Our outcome was AIMT after 3 years (Y3) of AI (any grade articular or muscular pain by CTCAE v4.0). Potential predictors at diagnosis (baseline), including clinical, behavioral, treatment-related and patient-reported (EORTC QLQ-C30, HADS) variables, were tested in a development cohort using multivariable logistic regression. The model was validated among pts from a later enrolment period.
Results
Among 3399 postmenopausal pts, 54.8% received letrozole as first AI, 39.9% anastrozole and 5.3% exemestane. Overall, 65.4% pts reported AIMT at Y3 (9.0% were grade 3). Higher BMI, previous osteoarticular disease (mainly arthrosis, bone fractures), self-reported baseline pain and anxiety emerged as AIMT determinants in the development cohort (n=2390). Patient-reported pain and anxiety were validated predictors (n=1009) (Table). When type of AI was included in the model, anastrozole was associated with increased AIMT risk (OR vs letrozole 1.39 [1.16-1.67] in the development and 1.40 [1.07-1.84] in the validation cohort). Table: 1818MO
Predictive models
| Development | Validation | |
| aOR (95% CI) | aOR (95% CI) | |
| Age, for a 5-year decrease | 1.07 (1.00-1.13) | - |
| Previous osteoarticular disease | 1.27 (1.06-1.52) | 0.95 (0.72-1.25) |
| BMI, for a 5-point increase | 1.16 (1.07-1.27) | 1.03 (0.91-1.16) |
| Pain, for a 5-point increase | 1.07 (1.05-1.10) | 1.05 (1.01-1.09) |
Anxiety, vs non-case (ConclusionsThis study provides a clinical predictive model of AIMT among postmenopausal pts with EBC after 3 years of AI, including targetable baseline factors such as pain and anxiety symptoms. Additional actionable behavioral targets emerging from model development include higher BMI. Further model refinement is warranted to better dissect the interindividual variability of this invalidating symptom. Clinical trial identificationNCT01993498, Release date 2012. Editorial acknowledgementLegal entity responsible for the studyUNICANCER. FundingCareer Pathway Grant in Symptom Management from Conquer Cancer, the American Society of Clinical Oncology (ASCO) - Rising Tide Foundation for Clinical Cancer Research - ARC Foundation for PhD program - ANR-10-COHO-0004 (CANTO) - ANR-18-IBHU-0002 (PRISM) - ANR-17-RHUS-008 (MYPROBE). DisclosureP. Lapidari: Other, Personal, Other, Travel expenses: Lilly. M. Lustberg: Financial Interests, Personal, Advisory Board: AstraZeneca, Novartis, Gilead; Financial Interests, Personal, Invited Speaker: Loxo Lilly; Financial Interests, Personal, Other, consultant: Pfizer. M. Pagliuca: Financial Interests, Personal, Other, Travel expenses: Gilead. C. Jouannaud: Financial Interests, Personal, Other, Honoraria: Pfizer, Daiichi Sankyo/ AstraZeneca/, Gilead; Financial Interests, Personal, Advisory Role: Daiichi Sankyo/ AstraZeneca/; Other, Personal, Other, Travel expenses: MSD Oncology, Viatris. W. Jacot: Financial Interests, Personal, Advisory Board: AstraZeneca, Eisai, Novartis, Roche, Pfizer, Eli Lilly, MSD, BMS, Chugai, Seagen, Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: AstraZeneca, Pfizer, Seagen, Daiichi Sankyo; Financial Interests, Personal, Advisory Board, Advisory Board: Gilead; Financial Interests, Institutional, Research Grant: AstraZeneca, Daiichi Sankyo; Financial Interests, Coordinating PI: Roche, Daiichi Sankyo; Financial Interests, Local PI: Roche, Novartis, Daiichi Sankyo. O. Tredan: Financial Interests, Personal, Advisory Board: Roche, Pfizer, Novartis-Sandoz, Lilly, MSD, AstraZeneca, Pierre Fabre Oncologie, Seagen, Daiichi Sankyo, Gilead, Eisai, Stemline-Menarini, Veracyte, Exact Sciences. M.A. Franzoi: Financial Interests, Institutional, Research Funding: Resilience Care; Financial Interests, Institutional, Speaker, Consultant, Advisor: Novartis. I.V. Vaz Luis: Financial Interests, Institutional, Invited Speaker: Amgen, Pfizer/Edimark, AstraZeneca; Financial Interests, Institutional, Writing Engagement: Pfizer/Edimark; Financial Interests, Institutional, Advisory Board, Consulting/ AB: Novartis; Financial Interests, Institutional, Advisory Board: Sandoz; Financial Interests, Personal, Other, Travelling: Novartis; Financial Interests, Institutional, Other, Research Funding: Resilience; Financial Interests, Institutional, Funding: Resilience; Non-Financial Interests, Member, Member of WG: ASCO. A. Di Meglio: Financial Interests, Personal, Advisory Board: Kephren, Medycis, Techspert. All other authors have declared no conflicts of interest. 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