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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Treatment Adherence and Its Impact on Disease-Free Survival in the Breast International Group 1-98 Trial of Tamoxifen and Letrozole, Alone and in Sequence</title><author><name sortKey="Chirgwin, Jacquie H" sort="Chirgwin, Jacquie H" uniqKey="Chirgwin J" first="Jacquie H." last="Chirgwin">Jacquie H. Chirgwin</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Giobbie Hurder, Anita" sort="Giobbie Hurder, Anita" uniqKey="Giobbie Hurder A" first="Anita" last="Giobbie-Hurder">Anita Giobbie-Hurder</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Coates, Alan S" sort="Coates, Alan S" uniqKey="Coates A" first="Alan S." last="Coates">Alan S. Coates</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Price, Karen N" sort="Price, Karen N" uniqKey="Price K" first="Karen N." last="Price">Karen N. Price</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Ejlertsen, Bent" sort="Ejlertsen, Bent" uniqKey="Ejlertsen B" first="Bent" last="Ejlertsen">Bent Ejlertsen</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Debled, Marc" sort="Debled, Marc" uniqKey="Debled M" first="Marc" last="Debled">Marc Debled</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Gelber, Richard D" sort="Gelber, Richard D" uniqKey="Gelber R" first="Richard D." last="Gelber">Richard D. Gelber</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Goldhirsch, Aron" sort="Goldhirsch, Aron" uniqKey="Goldhirsch A" first="Aron" last="Goldhirsch">Aron Goldhirsch</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Smith, Ian" sort="Smith, Ian" uniqKey="Smith I" first="Ian" last="Smith">Ian Smith</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Rabaglio, Manuela" sort="Rabaglio, Manuela" uniqKey="Rabaglio M" first="Manuela" last="Rabaglio">Manuela Rabaglio</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Forbes, John F" sort="Forbes, John F" uniqKey="Forbes J" first="John F." last="Forbes">John F. Forbes</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Neven, Patrick" sort="Neven, Patrick" uniqKey="Neven P" first="Patrick" last="Neven">Patrick Neven</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Lang, Istvan" sort="Lang, Istvan" uniqKey="Lang I" first="István" last="Láng">István Láng</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Colleoni, Marco" sort="Colleoni, Marco" uniqKey="Colleoni M" first="Marco" last="Colleoni">Marco Colleoni</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Thurlimann, Beat" sort="Thurlimann, Beat" uniqKey="Thurlimann B" first="Beat" last="Thürlimann">Beat Thürlimann</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27217455</idno><idno type="pmc">4962733</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962733</idno><idno type="RBID">PMC:4962733</idno><idno type="doi">10.1200/JCO.2015.63.8619</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000464</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000464</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Treatment Adherence and Its Impact on Disease-Free Survival in the Breast International Group 1-98 Trial of Tamoxifen and Letrozole, Alone and in Sequence</title><author><name sortKey="Chirgwin, Jacquie H" sort="Chirgwin, Jacquie H" uniqKey="Chirgwin J" first="Jacquie H." last="Chirgwin">Jacquie H. Chirgwin</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Giobbie Hurder, Anita" sort="Giobbie Hurder, Anita" uniqKey="Giobbie Hurder A" first="Anita" last="Giobbie-Hurder">Anita Giobbie-Hurder</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Coates, Alan S" sort="Coates, Alan S" uniqKey="Coates A" first="Alan S." last="Coates">Alan S. Coates</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Price, Karen N" sort="Price, Karen N" uniqKey="Price K" first="Karen N." last="Price">Karen N. Price</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Ejlertsen, Bent" sort="Ejlertsen, Bent" uniqKey="Ejlertsen B" first="Bent" last="Ejlertsen">Bent Ejlertsen</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Debled, Marc" sort="Debled, Marc" uniqKey="Debled M" first="Marc" last="Debled">Marc Debled</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Gelber, Richard D" sort="Gelber, Richard D" uniqKey="Gelber R" first="Richard D." last="Gelber">Richard D. Gelber</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Goldhirsch, Aron" sort="Goldhirsch, Aron" uniqKey="Goldhirsch A" first="Aron" last="Goldhirsch">Aron Goldhirsch</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Smith, Ian" sort="Smith, Ian" uniqKey="Smith I" first="Ian" last="Smith">Ian Smith</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Rabaglio, Manuela" sort="Rabaglio, Manuela" uniqKey="Rabaglio M" first="Manuela" last="Rabaglio">Manuela Rabaglio</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Forbes, John F" sort="Forbes, John F" uniqKey="Forbes J" first="John F." last="Forbes">John F. Forbes</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Neven, Patrick" sort="Neven, Patrick" uniqKey="Neven P" first="Patrick" last="Neven">Patrick Neven</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Lang, Istvan" sort="Lang, Istvan" uniqKey="Lang I" first="István" last="Láng">István Láng</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Colleoni, Marco" sort="Colleoni, Marco" uniqKey="Colleoni M" first="Marco" last="Colleoni">Marco Colleoni</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author><author><name sortKey="Thurlimann, Beat" sort="Thurlimann, Beat" uniqKey="Thurlimann B" first="Beat" last="Thürlimann">Beat Thürlimann</name><affiliation><nlm:aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Clinical Oncology</title><idno type="ISSN">0732-183X</idno><idno type="eISSN">1527-7755</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To investigate adherence to endocrine treatment and its relationship with disease-free survival (DFS) in the Breast International Group (BIG) 1-98 clinical trial.</p></sec><sec><title>Methods</title><p>The BIG 1-98 trial is a double-blind trial that randomly assigned 6,193 postmenopausal women with hormone receptor–positive early breast cancer in the four-arm option to 5 years of tamoxifen (Tam), letrozole (Let), or the agents in sequence (Let-Tam, Tam-Let). This analysis included 6,144 women who received at least one dose of study treatment. Conditional landmark analyses and marginal structural Cox proportional hazards models were used to evaluate the relationship between DFS and treatment adherence (persistence [duration] and compliance with dosage). Competing risks regression was used to assess demographic, disease, and treatment characteristics of the women who stopped treatment early because of adverse events.</p></sec><sec><title>Results</title><p>Both aspects of low adherence (early cessation of letrozole and a compliance score of < 90%) were associated with reduced DFS (multivariable model hazard ratio, 1.45; 95% CI, 1.09 to 1.93; <italic>P</italic> = .01; and multivariable model hazard ratio, 1.61; 95% CI, 1.08 to 2.38; <italic>P</italic> = .02, respectively). Sequential treatments were associated with higher rates of nonpersistence (Tam-Let, 20.8%; Let-Tam, 20.3%; Tam 16.9%; Let 17.6%). Adverse events were the reason for most trial treatment early discontinuations (82.7%). Apart from sequential treatment assignment, reduced adherence was associated with older age, smoking, node negativity, or prior thromboembolic event.</p></sec><sec><title>Conclusion</title><p>Both persistence and compliance are associated with DFS. Toxicity management and, for sequential treatments, patient and physician awareness, may improve adherence.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Oncol</journal-id><journal-id journal-id-type="iso-abbrev">J. Clin. Oncol</journal-id><journal-id journal-id-type="hwp">jco</journal-id><journal-id journal-id-type="pmc">jco</journal-id><journal-id journal-id-type="publisher-id">JCO</journal-id><journal-title-group><journal-title>Journal of Clinical Oncology</journal-title></journal-title-group><issn pub-type="ppub">0732-183X</issn><issn pub-type="epub">1527-7755</issn><publisher><publisher-name>American Society of Clinical Oncology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27217455</article-id><article-id pub-id-type="pmc">4962733</article-id><article-id pub-id-type="publisher-id">638619</article-id><article-id pub-id-type="doi">10.1200/JCO.2015.63.8619</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>Bc7</subject></subj-group><subj-group subj-group-type="heading"><subject>ORIGINAL REPORTS</subject><subj-group><subject>Breast Cancer</subject></subj-group></subj-group></article-categories><title-group><article-title>Treatment Adherence and Its Impact on Disease-Free Survival in the Breast International Group 1-98 Trial of Tamoxifen and Letrozole, Alone and in Sequence</article-title><alt-title alt-title-type="short">Treatment Adherence in the BIG 1-98 Trial</alt-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Chirgwin</surname><given-names>Jacquie H.</given-names></name><xref ref-type="aff" rid="aff1"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Giobbie-Hurder</surname><given-names>Anita</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Coates</surname><given-names>Alan S.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Price</surname><given-names>Karen N.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Ejlertsen</surname><given-names>Bent</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Debled</surname><given-names>Marc</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Gelber</surname><given-names>Richard D.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Goldhirsch</surname><given-names>Aron</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Ian</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Rabaglio</surname><given-names>Manuela</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Forbes</surname><given-names>John F.</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Neven</surname><given-names>Patrick</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Láng</surname><given-names>István</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Colleoni</surname><given-names>Marco</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Thürlimann</surname><given-names>Beat</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><aff id="aff1">Jacquie H. Chirgwin and John F. Forbes, University of Newcastle; John F. Forbes, Calvary Mater Newcastle, Newcastle; Alan S. Coates, University of Sydney School of Public Health, Sydney, New South Wales; Jacquie H. Chirgwin, Box Hill Hospital; Jacquie H. Chirgwin, Maroondah Hospital; Jacquie H. Chirgwin, Monash University, Melbourne, Victoria, Australia; Anita Giobbie-Hurder, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute; Karen N. Price and Richard D. Gelber, Frontier Science and Technology Research Foundation; Richard D. Gelber, Harvard Medical School, Boston, MA; Bent Ejlertsen, Rigshospitalet, Copenhagen, Denmark; Marc Debled, Institut Bergonié, Bordeaux, France; Aron Goldhirsch and Marco Colleoni, European Institute of Oncology, Milan, Italy; Ian Smith, The Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom; Manuela Rabaglio, Inselspital, Bern; Beat Thürlimann, Kantonsspital, St. Gallen, Switzerland; Patrick Neven, University of Leuven; Patrick Neven, University Hospitals Leuven, Leuven, Belgium; István Láng, National Institute of Oncology, Budapest, Hungary.</aff></contrib-group><author-notes><corresp id="cor1">Corresponding author: Jacquie H. Chirgwin, MD, Maroondah Breast Clinic, 20 Grey St, Ringwood East, Victoria 3135, Australia; e-mail: <email>chirgwin@tpg.com.au</email>.</corresp></author-notes><pub-date pub-type="ppub"><day>20</day><month>7</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>23</day><month>5</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>20</day><month>7</month><year>2017</year></pub-date><pmc-comment> PMC Release delay is 12 months and
0 days and was based on the
<volume>34</volume><issue>21</issue><fpage>2452</fpage><lpage>2459</lpage><permissions><copyright-statement>© 2016 by American Society of Clinical Oncology</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>American Society of Clinical Oncology</copyright-holder></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="JCO638619.pdf"></self-uri><abstract><sec><title>Purpose</title><p>To investigate adherence to endocrine treatment and its relationship with disease-free survival (DFS) in the Breast International Group (BIG) 1-98 clinical trial.</p></sec><sec><title>Methods</title><p>The BIG 1-98 trial is a double-blind trial that randomly assigned 6,193 postmenopausal women with hormone receptor–positive early breast cancer in the four-arm option to 5 years of tamoxifen (Tam), letrozole (Let), or the agents in sequence (Let-Tam, Tam-Let). This analysis included 6,144 women who received at least one dose of study treatment. Conditional landmark analyses and marginal structural Cox proportional hazards models were used to evaluate the relationship between DFS and treatment adherence (persistence [duration] and compliance with dosage). Competing risks regression was used to assess demographic, disease, and treatment characteristics of the women who stopped treatment early because of adverse events.</p></sec><sec><title>Results</title><p>Both aspects of low adherence (early cessation of letrozole and a compliance score of < 90%) were associated with reduced DFS (multivariable model hazard ratio, 1.45; 95% CI, 1.09 to 1.93; <italic>P</italic> = .01; and multivariable model hazard ratio, 1.61; 95% CI, 1.08 to 2.38; <italic>P</italic> = .02, respectively). Sequential treatments were associated with higher rates of nonpersistence (Tam-Let, 20.8%; Let-Tam, 20.3%; Tam 16.9%; Let 17.6%). Adverse events were the reason for most trial treatment early discontinuations (82.7%). Apart from sequential treatment assignment, reduced adherence was associated with older age, smoking, node negativity, or prior thromboembolic event.</p></sec><sec><title>Conclusion</title><p>Both persistence and compliance are associated with DFS. Toxicity management and, for sequential treatments, patient and physician awareness, may improve adherence.</p></sec></abstract><counts><fig-count count="5"></fig-count><table-count count="2"></table-count><equation-count count="0"></equation-count><ref-count count="52"></ref-count><page-count count="12"></page-count></counts><custom-meta-group><custom-meta><meta-name> DJS Export </meta-name><meta-value>v1</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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