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 sub-study
Markopoulos C et al. - In a study to compare the effect of exemestane on the lipid profile of postmenopausal pts with operable breast cancer in the adjuvant setting, to that of observation alone following completion of 5 to 7 yrs primary treatment with tamoxifen, it was found that exemestane lacks the beneficial effect of tamoxifen on lipids; however, sequential adjuvant treatment with exemestane in postmenopausal breast cancer pts following cessation of 5 to 7 yrs of tamoxifen does not appear to significantly alter the lipid profile vs an observational arm. Methods- In this open-label, randomized, parallel group study, 411 postmenopausal pts with operable breast cancer who have been treated with tamoxifen for 5 to 7 yrs, were randomized to either 5 additional yrs of exemestane (25 mg/day; n=211) or observation only (n=200).
- Assessments of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total serum triglycerides (TRG) were performed at baseline and then during each follow up visit, performed at either 6 or 12 mos according to the center's clinical practice, until completing 24 mos in the study.
Results- TC and LDL levels increased significantly across time for both arms; TC increase was more pronounced for the observation arm and that was sustained up to 24 mos.
- HDL levels decreased significantly across time for the exemestane arm, while no significant change was detected across time for the observation arm.
- Triglyceride levels decreased significantly across time on both arms with no difference detected in changes from baseline between exemestane and observation arm.
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