The Burden of Illness of Treatment-Induced Vasomotor Symptoms in Patients With Breast Cancer: A Systematic Literature Review

OBJECTIVES: This systematic literature review (SLR) assessed the global burden of treatment-related vasomotor symptoms (VMS) in patients with breast cancer (BC) receiving tamoxifen or aromatase inhibitors (AIs).

METHODS: Embase and PubMed were searched for observational and interventional studies published from January 2010 to January 2023. The population of interest was adults receiving tamoxifen or AIs for BC who experienced moderate-to-severe treatment-related VMS. Literature screening and data extraction were conducted by one researcher with quality checks by a second researcher. The review included epidemiological, clinical, humanistic, and economic data.

RESULTS: Of 694 publications identified, 37 independent studies (22 observational and 15 interventional) met the inclusion criteria. Most studies focused on post-menopausal women with early-stage BC, analyzing interventions such as tamoxifen, anastrozole, and exemestane. Prevalence or incidence were reported in 18 studies. Prevalence ranged from 7.3% to 83% in observational studies, while incidence rates ranged from 22.1% to 34.8% at 12 months in interventional studies. Data from 4 studies suggested that patients experienced treatment-related VMS with a frequency of 2 to 20 episodes per day, but data on timing, duration, and correlations with clinical outcomes were limited. Potential risk factors for treatment-related VMS included age, weight gain, body mass index, ethnicity, employment intensity, and certain genetic haplotypes; however, these data were often available in only one study. Gaps in the available evidence included treatment options/management strategies for treatment-related VMS and the economic burden of treatment-related VMS.

CONCLUSIONS: This SLR highlights the significant burden of illness associated with treatment-related VMS in women with BC receiving tamoxifen or AI therapy. Several studies reported a large proportion of women had moderate-to-severe symptoms. Our study also revealed important gaps in the evidence, suggesting additional research is required to understand the unmet needs for this population.