The effect of exemestane, anastrozole, and tamoxifen on lipid profiles in Japanese postmenopausal early breast cancer patients: final results of National Surgical Adjuvant Study BC 04, the TEAM Japan sub-study.

BACKGROUND In this Tamoxifen Exemestane Adjuvant Multinational Japan sub-study, we evaluated the time course of changes in serum lipids in postmenopausal women with hormone-sensitive early breast cancer treated with exemestane, anastrozole, or tamoxifen for postoperative adjuvant therapy. PATIENTS AND METHODS A total of 154 breast cancer patients were assigned to receive exemestane, anastrozole, or tamoxifen in this randomized open-label study. Serum lipid parameters including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured during 1 year of treatment. RESULTS TC and LDL-C rapidly decreased in patients treated with tamoxifen at 3 months. Compared with anastrozole and exemestane patients, TC and LDL-C were significantly lower at all assessment time points in tamoxifen patients (P < 0.05). TG increased in tamoxifen patients; it was significantly higher compared with exemestane patients at all assessment time points (P < 0.05). HDL-C slightly decreased in exemestane patients; it was significantly lower compared with anastrozole patients at 3 months and 1 year (P = 0.0179 and 0.0013, respectively). CONCLUSION Changes of lipid profiles in Japanese postmenopausal women treated with tamoxifen were relatively favorable, while exemestane and anastrozole had no clinically significant effect on the serum lipids.

[1]  H. Iwata,et al.  Phase III randomized adjuvant study of tamoxifen alone versus sequential tamoxifen and anastrozole in Japanese postmenopausal women with hormone-responsive breast cancer: N-SAS BC03 study , 2010, Breast Cancer Research and Treatment.

[2]  U. Dafni,et al.  Extended adjuvant hormonal therapy with exemestane has no detrimental effect on the lipid profile of postmenopausal breast cancer patients: final results of the ATENA lipid substudy , 2009, Breast Cancer Research.

[3]  R. Petrioli,et al.  The effects on lipid serum levels of a 2-year adjuvant treatment with exemestane after tamoxifen in postmenopausal women with early breast cancer. , 2008, European journal of internal medicine.

[4]  R. Petrioli,et al.  Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer , 2008, Clinical interventions in aging.

[5]  R. Eastell,et al.  Effects of third generation aromatase inhibitors on bone health and other safety parameters: results of an open, randomised, multi-centre study of letrozole, exemestane and anastrozole in healthy postmenopausal women. , 2007, European journal of cancer.

[6]  P. Lønning,et al.  Survival and safety of exemestane versus tamoxifen after 2–3 years' tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial , 2007, The Lancet.

[7]  H. Gogas,et al.  Duration of Tamoxifen Effect on Lipidemic Profile of Postmenopausal Breast Cancer Patients following Deprivation of Treatment , 2006, Oncology.

[8]  J. Cuzick,et al.  Comprehensive side-effect profile of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: long-term safety analysis of the ATAC trial. , 2006, The Lancet. Oncology.

[9]  D. Amadori,et al.  Switching to anastrozole versus continued tamoxifen treatment of early breast cancer. Updated results of the Italian tamoxifen anastrozole (ITA) trial. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[10]  H. Gogas,et al.  The Effect of Exemestane on the Lipidemic Profile of Postmenopausal Early Breast Cancer Patients: Preliminary Results of the TEAM Greek Sub-study , 2005, Breast Cancer Research and Treatment.

[11]  P. Lønning,et al.  Effects of exemestane administered for 2 years versus placebo on bone mineral density, bone biomarkers, and plasma lipids in patients with surgically resected early breast cancer. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  E. Perez,et al.  The influence of letrozole on serum lipid concentrations in postmenopausal women with primary breast cancer who have completed 5 years of adjuvant tamoxifen (NCIC CTG MA.17L). , 2005, Annals of oncology : official journal of the European Society for Medical Oncology.

[13]  A. Yonemura,et al.  Effect of anastrozole and tamoxifen on lipid metabolism in Japanese postmenopausal women with early breast cancer , 2005, Acta oncologica.

[14]  M Baum,et al.  Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer , 2005, The Lancet.

[15]  P. Berger,et al.  Christianity and Democracy: The Global Picture , 2004 .

[16]  P. Lønning,et al.  Cognitive ability in childhood and cognitive decline in mid-life: longitudinal birth cohort study , 2003, BMJ : British Medical Journal.

[17]  E. Perez,et al.  A Randomized Trial of Letrozole in Postmenopausal Women after Five Years of Tamoxifen Therapy for Early-Stage Breast Cancer , 2003 .

[18]  J. Cuzick,et al.  Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early‐stage breast cancer , 2003, Cancer.

[19]  P. Goss.  Emerging Role of Aromatase Inhibitors in the Adjuvant Setting , 2003, American journal of clinical oncology.

[20]  P. Lønning,et al.  Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[21]  F. Bray,et al.  Cancer burden in the year 2000. The global picture. , 2001, European journal of cancer.

[22]  R B Mazess,et al.  Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer. , 1992, The New England journal of medicine.

[23]  U. Dafni,et al.  Lipid changes in breast cancer patients on exemestane treatment: final results of the TEAM Greek substudy. , 2009, Annals of oncology : official journal of the European Society for Medical Oncology.