Exploring adherence in patients with advanced breast cancer: focus on CDK4/6 inhibitors

Treatment adherence is crucial for optimal outcomes in advanced breast cancer, but can be challenging due to various factors, i.e. patients' attitudes and behavior upon diagnosis, and complex therapies with high adverse effect rates. Our aim was to explore the adherence to oral anticancer medications (OAM) in women with advanced breast cancer, focusing on cyclin-dependent kinase 4 and 6 inhibitors (CDKI), and identify factors associated with the adherence. We conducted a cross-sectional study at the University Hospital Centre Zagreb, Croatia, involving women with stage IV advanced breast cancer receiving OAM. Data collection included a questionnaire assessing socio-demographic and clinical information, Beck Depression Inventory-II for depressive symptoms, Medication Adherence Report Scale (MARS-5) for adherence to OAM, and Beliefs about Medicines Questionnaire. Plasma concentrations of CDKI were confirmed by LC-MS/MS in three randomly selected participants. A total of 89 women were included. The most prescribed OAMs were anti-estrogen (71.3 %) and CDKI (60.9 %). MARS-5 scores (mean: 24.1 ± 1.6) correlated with CDKI plasma concentrations. Forgetfulness was the primary reason for non-adherence (25.9 %). Women receiving CDKI (p = 0.018), without depressive symptomatology (p = 0.043), and with more positive beliefs about medicines were more adherent (p < 0.05). This study enhances understanding of medication adherence in advanced breast cancer and identifies influential factors.

Polymorphonuclear leucocyte and natural killer cell functions in mature and premature newborns

In this study the phagocytic and natural killer cell (NK) functions in 17 premature and 30 mature newborns are compared. The ability of polymorphonuclear phagocytes (PMNs) to ingest, digest and lyse (antibody-dependent cell-mediated cytotoxicity, ADCC) opsonized sheep red blood cells and NK activity were tested. Examinations were performed in cord and venous blood within 6 h or 3-4 days after delivery. Results of examinations were compared with normal values for the group of healthy 4- to 15-year-old children. To assess the influence of the newborn's maturity and age on the tested PMNs and NK functions, the following comparisons were made. (1) Cord vs. peripheral venous blood: only ADCC was higher in peripheral than in cord blood. (2) Mature newborn cells obtained either 6 h or 3-4 days after delivery: ingestion and ADCC were lower and NK activity was higher 3-4 days after delivery. (3) Premature vs. mature newborn cells tested 3-4 days after delivery: ingestion and ADCC were higher while NK activity was lower in premature newborns. (4) Premature newborns tested at 3-4 days vs. mature newborns tested within 6 h after birth: ingestion was lower in the prematures while digestion, ADCC and NK activity were similar. (5) Cells from all newborns tested vs. those of healthy older children: results depend on the interval after birth when newborns were tested. Thus, within the first 6 h after delivery, mature newborns had higher ingestion and ADCC capacity but lower digestion and NK activity. Later, 3-4 days after birth, ingestion, ADCC and NK activity were lower in mature newborns. In the prematures at that interval NK activity was lower. (6) There was a positive correlation between gestational age and NK activity of newborns.