title: Correlation of treatment-emergent adverse events and clinical response to endocrine therapy in early breast cancer: a retrospective analysis of the German cohort of TEAM.
abstract: BACKGROUND
  Previous studies have suggested a correlation between the occurrence of vasomotor or joint symptoms during tamoxifen or aromatase inhibitor treatment and improved clinical response.
  
  
  METHODS
  A retrospective analysis of the German cohort of the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial was carried out to assess disease-free survival (DFS) and overall survival (OS) in patients with and without arthralgia/myalgia and/or menopausal symptoms during adjuvant endocrine treatment.
  
  
  RESULTS
  A total of 1502 patients were included; 739 patients received tamoxifen followed by exemestane and 763 received exemestane. Patients reporting arthralgia/myalgia and patients reporting menopausal symptoms during endocrine treatment had significantly longer OS and DFS than those not reporting these events. The effect on OS was irrespective of treatment. DFS was significantly improved in exemestane-treated patients reporting arthralgia/myalgia or those reporting menopausal symptoms versus those not reporting these events. This effect on DFS was not observed in patients receiving sequential treatment. A combined analysis of patients reporting either menopausal symptoms or arthralgia/myalgia showed that OS and DFS were significantly improved in patients reporting one of these symptoms versus those not reporting either symptom.
  
  
  CONCLUSIONS
  The occurrence of arthralgia/myalgia or menopausal symptoms during endocrine treatment is associated with significantly improved OS.
authors.affiliation: Departments of Gynaecological Endocrinology, Reproductive Medicine and Osteoporosis, University Hospital of Giessen and Marburg, Marburg. Electronic address: hadji@med.uni-marburg.de.
authors.forename: P
authors.initials: P
authors.lastname: Hadji
authors.affiliation: Department of Obstetrics and Gynaecology, Elblandkliniken, Meissen.
authors.forename: D G
authors.initials: DG
authors.lastname: Kieback
authors.affiliation: Biostatistics Department, ICRC-Weyer GmbH, Berlin.
authors.forename: J
authors.initials: J
authors.lastname: Tams
authors.affiliation: Department of Gynaecology and Gynaecologic Oncology, University Hospital Freiburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hasenburg
authors.affiliation: Departments of Gynaecological Endocrinology, Reproductive Medicine and Osteoporosis, University Hospital of Giessen and Marburg, Marburg.
authors.forename: M
authors.initials: M
authors.lastname: Ziller
mesh_terms: D000368:Aged; D000730:Androstadienes / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013629:Tamoxifen / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000730:Androstadienes; D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; C056516:exemestane