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Effects of toremifene versus tamoxifen on breast cancer patients: a meta-analysis

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Abstract

Toremifene and tamoxifen are both selective estrogen receptor modulators used in the treatment of breast cancer patients. Therefore, we carried out a meta-analysis to achieve a more precise evaluation of the effects of toremifene versus tamoxifen on breast cancer patients, including the efficacy and safety, and the effects on the uterus, lipids, and bone. Comprehensive literature searches were conducted using the electronic databases and reference lists to include randomized controlled trials (RCTs) that compared toremifene with tamoxifen for breast cancer patients. Two reviewers independently selected studies and abstracted data. Data were analyzed by Review Manager, version 5.0. Twenty-three trials (7242 patients) were included. For early stage breast cancer, toremifene was associated with higher 5-year survival rates (OR 1.25, 95 % CI 1.04, 1.50), more vaginal discharge (OR 1. 32, 95 % CI 1.01, 1.73), a greater decrease in serum triglyceride levels (SMD −1.01, 95 % CI −1.89, −0.14), a smaller decrease in LDL cholesterol levels (SMD 0.45, 95 % CI 0.07, 0.84) and in bone mineral density in Ward’s triangle (SMD −0.36, 95 % CI −0.71, −0.01), and a greater increase in HDL cholesterol levels (SMD 0.43, 95 % CI 0.08, 0.77) than tamoxifen. For advanced breast cancer patients, toremifene was associated with more vaginal bleeding (OR 0.45, 95 % CI 0.26, 0.80) and a greater decrease in serum triglyceride levels (SMD −1.15, 95 % CI −1.90, −0.39) than tamoxifen. Available evidence showed that toremifene could be an alternative option to tamoxifen for both early and advanced breast cancer patients. However, the methodological quality of the included studies was low. More rigorous RCTs are needed to confirm the results of this meta-analysis in the future.

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Authors and Affiliations

  1. Department of Medical Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang, 110022, China

    Feng Chi, Rong Wu, Yuecan Zeng, Rui Xing, Yang Liu & Zhaoguo Xu

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  1. Feng Chi
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  2. Rong Wu
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  3. Yuecan Zeng
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  4. Rui Xing
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  5. Yang Liu
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  6. Zhaoguo Xu
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Correspondence to Feng Chi.

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Chi, F., Wu, R., Zeng, Y. et al. Effects of toremifene versus tamoxifen on breast cancer patients: a meta-analysis. Breast Cancer 20, 111–122 (2013). https://doi.org/10.1007/s12282-012-0430-6

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  • DOI: https://doi.org/10.1007/s12282-012-0430-6

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