title: Fulvestrant treatment is associated with cholesterol plasma level reduction in hormone-receptor-positive metastatic breast cancer patients.
abstract: BACKGROUND
  Fulvestrant is a pure anti-estrogen hormoal agent formally lacking any estrogen-agonist activity. We analyze the effect(s) of fulvestrant treatment on estrogen target systems in hormoe-sensitive advanced breast cancer patients.
  
  
  RESULTS
  Patients received a median of five fulvestrant injections (range 3-19). We observed a partial response in one patient, disease stability in 21 and disease progression in 29 patients with a clinical benefit of 43.2% and a median time to progression of 5 [range 3-20] mo. Total cholesterol levels significantly decreased during treatment (219.8 +/- 45.3 vs. 201.4 +/- 42.1 mg/dl; p = 0.0054) together with LDL-cholesterol (129.7 +/- 41.39 vs. 112.3 +/- 37.1 mg/dl; p = 0.018). HDL-cholesterol and triglycerides did not show significant changes. Reduction of total and LDL-cholesterol was independent from last hormoal treatment or treatment duration. All coagulation indices and mean endometrial mucosa thickness value did not vary.
  
  
  METHODS
  Fifty-one patients [median age 65 (range 48-82) y] were enrolled. All patients received previous hormoal treatments, with 90.2% receiving > or =2 courses. Last hormoal treatment was exemestane, letrozole, anastrozole and other in 30-10-7-4/51 patients respectively. Median withdrawal time was 18 d (range 3-1456). Complete fasting lipid blood profile and coagulation indices were assessed before fulvestrant administration, every 3 mo and at discontinuation time. Endometrial mucosa thickness was evaluated before fulvestrant administration and at end-study time.
  
  
  CONCLUSIONS
  We observed a lipid lowering effect of fulvestrant possibly related to an influence on lipid metabolism by a mechanism in which a role could be played by progesterone receptor.
authors: Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Italy. andreacamerini@katamail.com
authors: Andrea
authors: A
authors: Camerini
authors: Marianna
authors: M
authors: Rondini
authors: Ornella
authors: O
authors: Garrone
authors: Chiara
authors: C
authors: Valsuani
authors: Sara
authors: S
authors: Donati
authors: Olimpia
authors: O
authors: Siclari
authors: Alessandro
authors: A
authors: Sgambato
authors: Gianna
authors: G
authors: Tartarelli
authors: Maura
authors: M
authors: Vincenti
authors: Valentina Polla
authors: VP
authors: Mattiot
authors: Romana Prosperi
authors: RP
authors: Porta
authors: Cheti
authors: C
authors: Puccetti
authors: Paolo
authors: P
authors: Puccinelli
authors: Domenico
authors: D
authors: Amoroso
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D004717:Endometrium / Q000187:drug effects / Q000648:ultrastructure; D004958:Estradiol / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D020847:Estrogen Receptor Modulators / Q000494:pharmacology* / Q000627:therapeutic use; D004967:Estrogens; D005260:Female; D000077267:Fulvestrant; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009376:Neoplasms, Hormone-Dependent / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D017698:Postmenopause; D011374:Progesterone; D011446:Prospective Studies; D011960:Receptors, Estrogen / Q000032:analysis* / Q000187:drug effects; D011980:Receptors, Progesterone / Q000032:analysis* / Q000187:drug effects / Q000502:physiology; D014280:Triglycerides / Q000097:blood
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D008078:Cholesterol, LDL; D020847:Estrogen Receptor Modulators; D004967:Estrogens; D009363:Neoplasm Proteins; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014280:Triglycerides; D000077267:Fulvestrant; D011374:Progesterone; D004958:Estradiol; D002784:Cholesterol