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

Research Article

Erwei Song¹  Liang Jin¹  Kai Chen¹  Weijuan Jia¹  Lili Chen¹  Qiaozhen Xiao¹  Shunrong Li¹  Jiannan Wu¹  Meijun Long¹  Yue Hu¹  Fengxi Su¹  Ran Gu¹  Nanyan Rao¹  Mei Wu¹  Yunjie Zeng²  Lijuan Chen³ 

[1] Department of Breast Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 510260, Guangzhou, China;Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 510260, Guangzhou, China;Republic Health, Sun Yat-Sen University, 510000, Guangzhou, China;

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

DOI  :  10.1186/1471-2407-12-161

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

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsPatients 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.ResultsOf 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.ConclusionToremifene may be a valid and safe alternative to tamoxifen in premenopausal women with endocrine-responsive breast cancer.

【 授权许可】

Unknown   
© Gu et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.