Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: A randomised, placebo-controlled study

Geisler, Jürgen; Lønning, Per Eystein; Krag, L. E.; Løkkevik, Erik; Risberg, Terje; Hagen, Anne Irene; Schlichting, Ellen; Lien, Ernst A.; Øfjord, Erik Snorre; Eide, Geir Egil; Polli, Anna; Salle, E. Di; Paolini, Jolanda

doi:10.1016/j.ejca.2006.07.005

Cited by 93 publications

(53 citation statements)

References 30 publications

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“…Indeed, 76-88 % of breast cancer survivors have low vitamin D levels, i.e. <20 ng/mL [147][148][149]. A recent study has shown that low vitamin D levels are highly prevalent among newly diagnosed breast cancer patients with nearly 44 % with vitamin D insufficiency [150].…”

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confidence: 99%

Cancer-associated bone disease

Rizzoli

Body²,

Brandi³

et al. 2013

Osteoporos Int

122

103

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Bone is commonly affected in cancer. Cancer-induced bone disease results from the primary disease, or from therapies against the primary condition, causing bone fragility. Bone-modifying agents, such as bisphosphonates and denosumab, are efficacious in preventing and delaying cancer-related bone disease. With evidence-based care pathways, guidelines assist physicians in clinical decision-making. Of the 57 million deaths in 2008 worldwide, almost two thirds were due to non-communicable diseases, led by cardiovascular diseases and cancers. Bone is a commonly affected organ in cancer, and although the incidence of metastatic bone disease is not well defined, it is estimated that around half of patients who die from cancer in the USA each year have bone involvement. Furthermore, cancer-induced bone disease can result from the primary disease itself, either due to circulating bone resorbing substances or metastatic bone disease, such as commonly occurs with breast, lung and prostate cancer, or from therapies administered to treat the primary condition thus causing bone loss and fractures. Treatment-induced osteoporosis may occur in the setting of glucocorticoid therapy or oestrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy. Tumour skeletal-related events include pathologic fractures, spinal cord compression, surgery and radiotherapy to bone and may or may not include hypercalcaemia of malignancy while skeletal complication refers to pain and other symptoms. Some evidence demonstrates the efficacy of various interventions including bone-modifying agents, such as bisphosphonates and denosumab, in preventing or delaying cancer-related bone disease. The latter includes treatment of patients with metastatic skeletal lesions in general, adjuvant treatment of breast and prostate cancer in particular, and the prevention of cancerassociated bone disease. This has led to the development of guidelines by several societies and working groups to assist physicians in clinical decision making, providing them with evidencebased care pathways to prevent skeletal-related events and bone loss. The goal of this paper is to put forth an IOF position paper addressing bone diseases and cancer and summarizing the position papers of other organizations. Epidemiology of cancer-associated bone disease Bone metastasisCancer affects nearly 12.7 million people and is associated with over 7 million deaths in 2008 [1]. Cancer is a rising global health burden and it is estimated that in 2030, cancer deaths will be tallied at over 13 million (World Health Organization (WHO) 2010 Global Status Report [2]). Addressing the morbidity and mortality of cancer is an important public health concern. On purpose, we are limiting our analysis to cancer bone involvement in adults and do not discuss cancer in children.Metastases from cancer are associated with 90 % of cancer deaths [3]. It was estimated that one half of people who die from cancer in the USA have bone involvement [4][5][6]. Different tumou...

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confidence: 99%

Cancer-associated bone disease

Rizzoli

Body²,

Brandi³

et al. 2013

Osteoporos Int

122

103

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“…Во всех адъювантных исследованиях частота переломов на ИА (3,1-11,0%) и остеопороза (7,4-8,1%) была достоверно выше, чем на тамоксифене, способном предотвращать потерю костной плотности [10,11,30,40]. В среднем еже-годная потеря костной плотности на терапии ИА состав-ляет 2,17% в поясничных позвонках и 2,72% в шейке бедра, через 2 года приема потери достигают 5,35% и 3,6% соответственно [47].…”

Section: скелетномышечные осложнения ингибиторов ароматазыunclassified

Adverse effects of adjuvant endocrine therapy

et al. 2018

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“…In a randomised, placebo-controlled study of postmenopausal women with early breast cancer, the decrease in BMD with exemestane when compared with placebo was partially reversed during a 1-year follow-up (Geisler et al 2006). Accordingly, in the exemestane arm of the IES randomised study, arm resorption marker measurements were the highest at 12 months and then decreased, while bone formation markers peaked between 18 and 24 months ).…”

Section: Side Effects: Osteoporosismentioning

confidence: 99%

“…A more favourable effect of steroidal AI on the bone is also suggested by animal laboratory data. Exemestane decreases overall bone turnover and prevents bone loss at the lumbar vertebrae and whole femora in ovariectomised rats (Geisler et al 2006), while these protective effects are not seen with the non-steroidal AI letrozole (Goss et al 2004a,b).…”

Section: Side Effects: Osteoporosismentioning

confidence: 99%

Aromatase inhibitors for breast cancer: different structures, same effects?

Ponzone¹,

Mininanni²,

Cassina³

et al. 2008

Endocrine Related Cancer

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Aromatase inhibitors (AIs) have become the first-choice endocrine drugs for postmenopausal breast cancer patients since they are associated with superior activity and better general tolerability when compared with tamoxifen both in the adjuvant and metastatic settings. As a consequence, the question is no more if a postmenopausal patient should have AIs as part of her adjuvant treatment, but when should it be started or which one should be preferentially used. Newer compounds, generally defined as third-generation AIs, are biochemically more selective and potent when compared with older ones, and they also show superior clinical activity. As yet, no large randomised study has been published comparing the three third-generation AIs on the market. Nevertheless, both laboratory and clinical data suggest that the steroidal (exemestane) and non-steroidal (anastrozole, letrozole) AIs may have slightly different toxicity profiles, probably due to the low androgenic action of the formers. While waiting for randomised data on clinical efficacy of third-generation AIs, such differences may help select the best drug in elderly patients with a low cumulative risk of relapse and a significant amount of co-morbidities, such as cardiovascular disease or osteoporosis.

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Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: A randomised, placebo-controlled study

Cited by 93 publications

References 30 publications

Cancer-associated bone disease

Cancer-associated bone disease

Adverse effects of adjuvant endocrine therapy

Aromatase inhibitors for breast cancer: different structures, same effects?

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