A comparison of survival outcomes and side effects of toremifene or tamoxifen therapy in premenopausal estrogen and progesterone receptor positive breast cancer patients: a retrospective cohort study

BMC Cancer

Ran Gu²  Weijuan Jia²  Yunjie Zeng³  Nanyan Rao²  Yue Hu²  Shunrong Li²  Jiannan Wu²  Liang Jin²  Lijuan Chen¹  Meijun Long²  Kai Chen²  Lili Chen²  Qiaozhen Xiao²  Mei Wu²  Erwei Song²  Fengxi Su² 

[1] Republic Health, Sun Yat-Sen University, Guangzhou, 510000, China

[2] Department of Breast Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510260, China

[3] Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510260, China

关键词: Premenopausal;    Adjuvant endocrine therapy;    Breast cancer;    Toremifene;    Tamoxifen;   

Others  :  1080446
DOI  :  10.1186/1471-2407-12-161

 received in 2011-05-05, accepted in 2012-03-03,  发布年份 2012

【 摘 要 】

Background

In premenopausal women, endocrine adjuvant therapy for breast cancer primarily consists of tamoxifen alone or with ovarian suppressive strategies. Toremifene is a chlorinated derivative of tamoxifen, but with a superior risk-benefit profile. In this retrospective study, we sought to establish the role of toremifene as an endocrine therapy for premenopausal patients with estrogen and/or progesterone receptor positive breast cancer besides tamoxifen.

Methods

Patients with early invasive breast cancer were selected from the breast tumor registries at the Sun Yat-Sen Memorial Hospital (China). Premenopausal patients with endocrine responsive breast cancer who underwent standard therapy and adjuvant therapy with toremifene or tamoxifen were considered eligible. Patients with breast sarcoma, carcinosarcoma, concurrent contralateral primary breast cancer, or with distant metastases at diagnosis, or those who had not undergone surgery and endocrine therapy were ineligible. Overall survival and recurrence-free survival were the primary outcomes measured. Toxicity data was also collected and compared between the two groups.

Results

Of the 810 patients reviewed, 452 patients were analyzed in the study: 240 received tamoxifen and 212 received toremifene. The median and mean follow up times were 50.8 and 57.3 months, respectively. Toremifene and tamoxifen yielded similar overall survival values, with 5-year overall survival rates of 100% and 98.4%, respectively (p = 0.087). However, recurrence-free survival was significantly better in the toremifene group than in the tamoxifen group (p = 0.022). Multivariate analysis showed that recurrence-free survival improved independently with toremifene (HR = 0.385, 95% CI = 0.154-0.961; p = 0.041). Toxicity was similar in the two treatment groups with no women experiencing severe complications, other than hot flashes, which was more frequent in the toremifene patients (p = 0.049). No patients developed endometrial cancer.

Conclusion

Toremifene may be a valid and safe alternative to tamoxifen in premenopausal women with endocrine-responsive breast cancer.

【 授权许可】

   
2012 Gu et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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