Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer
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Weight gain is commonly reported by breast cancer patients on tamoxifen or aromatase inhibitors. Since weight gain may impact on outcome and compliance we have prospectively assessed the effects of these agents on weight change in three randomised trials for the treatment or prevention of breast cancer. Data on weight change in postmenopausal women from three large clinical trials investigating endocrine therapy for the treatment or prevention of breast cancer were analysed (ATAC, IBIS-I and IBIS-II). In the IBIS-I study, mean weight change on tamoxifen was +0.1 kg (SD 0.1) compared with +0.3 kg (SD 0.1) in women taking the placebo (P = 0.3) between baseline and 12 months of follow-up. In the IBIS-II trial, no statistically significant difference was found between anastrozole and placebo after 12 months of follow-up [+0.8 kg (SD 5.3) vs. +0.5 kg (SD 7.4), P = 0.5]. In the ATAC trial, no statistically significant differences in weight gain between anastrozole and tamoxifen were found after 12 months of follow-up [+1.4 kg (SD 3.9) vs. +1.5 kg (SD 4.0), P = 0.4]. Significant baseline predictors for gaining more than 5 kg of weight after 12 months of follow-up were: being younger than 60 years old, smoking and mastectomy. All three trials demonstrate that weight gain occurs primarily within the first 12 months of active treatment in a subset of patients. In the prevention trials, weight gain does not differ between anastrozole, tamoxifen and placebo and also did not differ between anastrozole and tamoxifen in the treatment trial.
KeywordsBreast cancer Weight changes Endocrine treatment
This analysis was supported by the Cancer Research UK and AstraZeneca.
Conflict of interest
Ivana Sestak, Michelle Harvie and Anthony Howell have no conflict of interest to declare. Jack Cuzick received research funding from AstraZeneca. John F. Forbes received honoraria from AstraZeneca and Novartis. Mitch Dowsett received consultancy fees, honoraria, research funding and expert testimony from AstraZeneca.
- 1.Tredan O, Bajard A, Meunier A, Roux P, Fiorletta I, Gargi T, Bachelot T, Guastalla JP, Lallemand Y, Faure C, Perol D, Bachmann P (2010) Body weight change in women receiving adjuvant chemotherapy for breast cancer: a French prospective study. Clin Nutr 29(2):187–191Google Scholar
- 2.Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, Rock CL, Pierce JP (2007) Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res Treat 105(2):177–186PubMedCrossRefGoogle Scholar
- 7.Carlini P, Bria E, Giannarelli D, Ferretti G, Felici A, Papaldo P, Fabi A, Nistico C, Di Cosimo S, Ruggeri EM, Milella M, Mottolese M, Terzoli E, Cognetti F (2005) New aromatase inhibitors as second-line endocrine therapy in postmenopausal patients with metastatic breast carcinoma: a pooled analysis of the randomized trials. Cancer 104(7):1335–1342PubMedCrossRefGoogle Scholar
- 9.Pfeiler G, Konigsberg R, Fesl C, Mlineritsch B, Stoeger H, Singer CF, Postlberger S, Steger GG, Seifert M, Dubsky P, Taucher S, Samonigg H, Bjelic-Radisic V, Greil R, Marth C, Gnant M (2010) Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol 29(19): 2653–2659Google Scholar
- 14.Nichols HB, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Holmes MD, Bersch AJ, Holick CN, Hampton JM, Stampfer MJ, Willett WC, Newcomb PA (2009) Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev 18(5):1403–1409PubMedCrossRefGoogle Scholar
- 17.Fisher B, Dignam J, Bryant J, DeCillis A, Wickerham DL, Wolmark N, Costantino J, Redmond C, Fisher ER, Bowman DM, Deschenes L, Dimitrov NV, Margolese RG, Robidoux A, Shibata H, Terz J, Paterson AH, Feldman MI, Farrar W, Evans J, Lickley HL (1996) Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors. J Natl Cancer Inst 88(21):1529–1542PubMedCrossRefGoogle Scholar
- 20.Baum M, Buzdar A, Cuzick J, Forbes J, Houghton J, Howell A, Sahmoud T (2003) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer 98(9):1802–1810PubMedCrossRefGoogle Scholar
- 25.Vrieling A, Buck K, Kaaks R, Chang-Claude J (2010) Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat 123(3):641–649Google Scholar
- 26.Vance V, Mourtzakis M, McCargar L, Hanning R (2010) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12(4): 282–294Google Scholar
- 28.Baum M, Budzar AU, Cuzick J, Forbes J, Houghton JH, Klijn JG, Sahmoud T (2002) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 359(9324):2131–2139PubMedCrossRefGoogle Scholar
- 30.Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, Hoctin-Boes G, Houghton J, Locker GY, Tobias JS (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365(9453):60–62PubMedCrossRefGoogle Scholar
- 31.Powles TJ, Ashley S, Tidy VA, Smith IE, Dowsett M (2006) 20 year follow-up of the Royal Marsden tamoxifen breast cancer prevention trials. In: San Antonio Breast Cancer Symposium. San AntonioGoogle Scholar
- 41.Nourissat A, Bairati I, Samson E, Fortin A, Gelinas M, Nabid A, Brochet F, Tetu B, Meyer F (2010) Predictors of weight loss during radiotherapy in patients with stage I or II head and neck cancer. Cancer 116(9):2275–2283Google Scholar
- 42.Langius JA, Doornaert P, Spreeuwenberg MD, Langendijk JA, Leemans CR, Schueren MA (2010) Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiother Oncol 97(1):80–85Google Scholar