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, A.; Caffarelli, C.; Del Santo, K.; Pieropan, C.; Campagna, M.S.; Montomoli, M.; Petrioli, R.; Nuti, R.

doi:10.1016/j.ejim.2007.05.016

« Previous Next »European Journal of Internal Medicine
Volume 19, Issue 8 , Pages 592-597, December 2008

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

A. Montagnani
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
- Corresponding author. Fax: +39 0577 233347.
S. Gonnelli
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
A. Cadirni
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
C. Caffarelli
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
K. Del Santo
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
C. Pieropan
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
M.S. Campagna
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
M. Montomoli
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy
R. Petrioli
- Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy
R. Nuti
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Italy

Received 9 February 2007; received in revised form 29 April 2007; accepted 6 May 2007. published online 01 April 2008.

Abstract

Background

The third-generation aromatase inhibitor exemestane represents a new development in the treatment of estrogen-positive breast cancer. The aim of this study was to evaluate the effects on lipid profile and body composition of the shift from tamoxifen to exemestane.

Methods

After 2–3years of tamoxifen adjuvant treatment, 68 postmenopausal women were randomly assigned to either continue tamoxifen 20 mg/day (n = 35) or to switch to exemestane 25 mg/day (n = 33).

Results

No significant changes in lipid profile were found in patients continuing on tamoxifen. In the exemestane group, serum HDL-cholesterol (HDL-C) and triglycerides (TG) decreased significantly (p < 0.01) and serum LDL-cholesterol (LDL-C) increased significantly (p < 0.05) with respect to baseline. The difference between the two groups was significant. Moreover, in the exemestane group, fat mass (FM) and fat-free mass (FFM) showed an opposite trend, which determined a progressive and significant increase in the FFM/FM ratio.

Conclusion

This study shows that the choice of first-line treatment or adjuvant therapy for breast cancer should also take the individual lipid and body composition profile into account.

Keywords: Lipid profile, Body composition, Aromatase inhibitors, Breast cancer, Cardiovascular risk