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Effects of toremifene and anastrozole on serum lipids and bone metabolism in postmenopausal females with estrogen receptor–positive breast cancer: the results of a 2-year multicenter open randomized study

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Abstract

The potential long-term adverse effects on quality of life have to be considered when selecting agents for adjuvant hormonal treatment for postmenopausal patients with estrogen receptor–positive breast cancer. We performed a 2-year multicenter randomized study to assess the differences in the time course effects between toremifene (TOR) and anastrozole (ANA) on serum lipid profiles and bone metabolism. This study assessed the serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-1 (Apo A1), and apolipoprotein B (Apo B) as lipid profiles and bone-specific alkaline phosphatase (BAP) and the N-telopeptide of type-I collagen (NTX) as bone turnover markers in patients who received daily doses of 40 mg and 1 mg for TOR and ANA, respectively. A decreased serum level of TC, LDL-C, and Apo B was, respectively, observed at 6 months in 6.2, 12.9, and 13.8% of the patients who received TOR compared with the baseline. These decreases were maintained for at least 24 months. These lipid levels were not changed in those who received ANA. In the TOR patients, there was an increase in the serum level of HDL-C and Apo A1 at 6 months in 17.1 and 16.3%, respectively, which was maintained for at least 24 months, whereas these levels were almost stable in the patients who received ANA. Serum BAP decreased by 12.1% at 12 months and further decreased at 24 months and the serum NTX decreased by 22.0% at 6 months, which was maintained for at least 24 months in the patients who received TOR. In contrast, the serum BAP was increased by 26.0% at 6 months and by 29.2% at 12 months and the serum NTX increased by 21.3% at 24 months compared with baseline in those received ANA. However, the serum BAP increase was not significant at 24 months. TOR provides better effects than ANA in terms of lipid profiles and bone metabolism in postmenopausal females with early breast cancer.

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Abbreviations

TOR:

Toremifene

ANA:

Anastrozole

CHD:

Coronary heart disease

TC:

Total cholesterol

TG:

Triglyceride

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

ApoA1:

Apolipoprotein A-1

ApoB:

Apolipoprotein B

BAP:

Bone-specific alkaline phosphatase

NTX:

N-telopeptide of type-I collagen

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Acknowledgments

This study received financial support from Nihonkayaku Co., Ltd. Japan. The following investigators and institutions also participated in the trial: Nobuaki Sato, Niigata Cancer Center Hospital, Niigata, Japan; Muneaki Sano, Niigata Breast Exam Center, Niigata, Japan; and Keisuke Miyauchi, Miyauchi Clinic, Hyogo, Japan

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Surgery, Kitakyushu Municipal Medical Center, Kokurakita-ku, 2-1-1, Bashaku, Kitakyushu, Fukuoka, 802-0077, Japan

    Keisei Anan & Shoshu Mitsuyama

  2. Gunma Prefectural Cancer Center, Gunma, Japan

    Yasuhiro Yanagita

  3. Ota General Hospital, Gunma, Japan

    Morihiko Kimura

  4. Okayama University Hospital, Okayama, Japan

    Hiroyoshi Doihara

  5. Breastopia Namba Hospital, Miyazaki, Japan

    Kansei Komaki

  6. Shinjuku Breast Center, Tokyo, Japan

    Mikihiro Kusama

  7. Teikyo University Hospital, Tokyo, Japan

    Tadashi Ikeda

Authors
  1. Keisei Anan
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  2. Shoshu Mitsuyama
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  3. Yasuhiro Yanagita
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  4. Morihiko Kimura
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  5. Hiroyoshi Doihara
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  6. Kansei Komaki
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  7. Mikihiro Kusama
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  8. Tadashi Ikeda
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Correspondence to Keisei Anan.

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Anan, K., Mitsuyama, S., Yanagita, Y. et al. Effects of toremifene and anastrozole on serum lipids and bone metabolism in postmenopausal females with estrogen receptor–positive breast cancer: the results of a 2-year multicenter open randomized study. Breast Cancer Res Treat 128, 775–781 (2011). https://doi.org/10.1007/s10549-011-1608-x

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  • DOI: https://doi.org/10.1007/s10549-011-1608-x

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