The effects on lipid serum levels of a 2-year adjuvant treatment with exemestane after tamoxifen in postmenopausal women with early breast cancer

Montagnani, A; Gonnelli, S.; Cadirni, Alice; Caffarelli, C.; Santo, Katelyn; Pieropan, C.; Campagna, Maria Stella; Montomoli, M.; Petrioli, Roberto; Nuti, Ranuccio

doi:10.1016/j.ejim.2007.05.016

Cited by 23 publications

(24 citation statements)

References 30 publications

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“…The results of the LDL-C level reduction by tamoxifen are consistent with previous series [7,10,11,12,17,18,19]. Tumor grade and lymph node status were not independent factors for the serum TC and LDL-C levels.…”

Section: Discussionsupporting

confidence: 91%

“…Of interest, some studies have suggested that adjuvant tamoxifen exhibits different effects on the lipid and liver profiles of cancer patients [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Researchers sought to determine the appropriate role of adjuvant tamoxifen in breast cancer patients regarding serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), aspartate transaminase (AST), and alanine transaminase (ALT) levels.…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant Tamoxifen Influences the Lipid Profile in Breast Cancer Patients

et al. 2014

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Background: Currently there is a debate regarding whether tamoxifen used in breast cancer has an impact on lipid profiles. The aim of this study was to determine whether tamoxifen has an impact on the serum lipid profile in Taiwanese women. Patients and Methods: Data of 109 patients were collected from the routine clinical follow-up for women with hormone receptor-positive breast cancer who were treated between July 2005 and March 2008. These patients were divided into 2 subgroups, based on their tumor grade and lymph node status. Subgroup 1 patients had tumor grade I/II and a negative lymph node status. Those patients with tumor grade III or a positive lymph node status were defined as subgroup 2. Results: In the 109 patients, the mean serum total cholesterol (TC) levels after tamoxifen treatment, as well as the serum low-density lipoprotein cholesterol (LDL-C) levels, were lower than the baseline levels, with statistically significant differences. Treatment with tamoxifen lowered the serum TC and LDL-C levels in both subgroups. Conclusions: The results indicate that tamoxifen has an impact on the serum lipid profile of breast cancer patients in Taiwan. Physicians should follow up the lipid profile in these patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Adjuvant Tamoxifen Influences the Lipid Profile in Breast Cancer Patients

et al. 2014

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“…Although very little information is available on the effect of AIs on body composition, the few published studies on this subject seemed to indicate no clinically significant adverse effect of AIs on body composition [15;25]. In a study by van Londen et al, women with breast cancer on AIs did not experience a significant increase in total body fat over the 2-years observation period [25].…”

Section: Discussionmentioning

confidence: 99%

“…Following the well-recognized association between central adiposity and cardiometabolic risk factors such as lipid profile and insulin sensitivity [13] it is possible that these women will have increase in cardiovascular risks with longer exposure to AIs. Previous studies have shown that women on AIs had significant reduction in high-density lipoprotein cholesterol and increase in low density lipoprotein cholesterol among women on exemestane relative to women on tamoxifen [9;15], suggesting a potential for AIs to have a negative impact on cardiovascular risks despite the overall higher ratio of fat free mass to fat mass.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge there are very few studies on the effect of AIs on body composition. Nevertheless, results from a study comparing the effect of tamoxifen and exemestane showed that contrary to what is expected for women with profound estrogen deficiency, women on exemestane had a significant reduction in fat mass and increase in the ratio of fat-free mass to fat mass compared to women on tamoxifen who demonstrated no significant changes in both parameters [9;15]. Furthermore, a recent study by van Londen et.al.…”

Section: Introductionmentioning

confidence: 99%

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Genetic polymorphism at Val80 (rs700518) of the CYP19A1 gene is associated with body composition changes in women on aromatase inhibitors for ER (+) breast cancer

Napoli

Rastelli

et al. 2015

Pharmacogenetics and Genomics

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Purpose Polymorphisms in the CYP19A1 (aromatase) gene influence disease-free survival and bone loss in patients taking aromatase inhibitors (AIs) for estrogen receptor positive (ER+) breast cancers. Because AI use results in profound estrogen deficiency which may lead to changes in body composition, the objective of this study was to determine the effect of the rs700518 polymorphism in the CYP19A1 gene, on the changes in body composition among postmenopausal women who were treated with AIs for ER+ breast cancer. Methods This is a 1-year prospective study of changes in body composition in postmenopausal women who were initiated on third-generation AIs for ER+ breast cancer. Body composition was measured by dual energy absorptiometry at 6 and 12 months, serum estradiol by radioimmunoassay and genotyping by Taqman SNP allelic discrimination assay. Results Eighty-two women were able to provide at least one follow-up body composition measurement. Women with the GG genotype for the rs700518 (G/A at Val80) developed a significant increase in Truncal fat mass index (p=0.03) and a significant decrease in fat-free mass index (p=0.01) at 12 months relative to patients carrying the A allele (GA/AA). There was no significant difference in the changes in estradiol levels among the genotypes. Conclusion Patients with the GG genotype for the rs700518 polymorphism in the CYP19A1 gene are at risk for significant loss of fat-free mass and increase in truncal fat with AI therapy. Whether there are associated metabolic abnormalities and whether changes would persist with long-term AI therapy, need to be confirmed in a larger study with a longer duration of follow-up.

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