title: Comparison of changes in the lipid profile of postmenopausal women with early stage breast cancer treated with exemestane or letrozole.
abstract: Effects of aromatase inhibitor (AI) therapy on the plasma lipid profile are not clear. Here the authors describe changes in fasting lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and triglycerides) before and after 3 months of exemestane or letrozole treatment. HDL was reduced in the entire cohort (P < .001) and in the exemestane group (P < .001) but unchanged in the letrozole group (P = .169). LDL was increased in the entire cohort (P = .005) and in the letrozole group (P = .002) but unchanged in the exemestane group (P = .361). This effect was at least partially attributable to washout of tamoxifen as only patients with prior use of tamoxifen experienced a significant increase in LDL. Baseline HDL was an independent predictor of the change in HDL (r(2) = -0.128, P < .001), and prior tamoxifen use was associated with greater increases in LDL (r(2) = 0.057, P < .001). Use of lipid-altering medications did not protect against the exemestane-induced drop in HDL or the increase in LDL observed in women with prior use of tamoxifen taking letrozole. In conclusion, AI treatment and/or washout of tamoxifen induced detrimental changes in the lipid profile of postmenopausal women with breast cancer.
authors.affiliation: Division of Clinical Pharmacology, Wishard Memorial Hospital, WD Myers Bldg, W7123, 1001 West 10th St, Indianapolis, IN 46202, USA. dflockha@iupui.edu
authors.forename: Lauren Nicole
authors.initials: LN
authors.lastname: Bell
authors.forename: Anne Thi Phuong
authors.initials: AT
authors.lastname: Nguyen
authors.forename: Lang
authors.initials: L
authors.lastname: Li
authors.forename: Zeruesenay
authors.initials: Z
authors.lastname: Desta
authors.forename: N Lynn
authors.initials: NL
authors.lastname: Henry
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hayes
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Wolff
authors.forename: Vered
authors.initials: V
authors.lastname: Stearns
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Storniolo
authors.forename: David A
authors.initials: DA
authors.lastname: Flockhart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000730:Androstadienes / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D047072:Aromatase Inhibitors / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077289:Letrozole; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D009570:Nitriles / Q000008:administration & dosage*; D017698:Postmenopause / Q000097:blood; D013629:Tamoxifen / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D000730:Androstadienes; D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D008055:Lipids; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077289:Letrozole; C056516:exemestane