Eye problems in breast cancer patients treated with tamoxifen

Paganini‐Hill, Annlia; Clark, Linda J.

doi:10.1023/a:1006342300291

Cited by 75 publications

(31 citation statements)

References 6 publications

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“…17 Posterior subcapsular cataract can occur with busulphan, 5,[18][19][20] methotrexate, 5 toremifene and tamoxifen. [21][22][23] In a prospective study of breast cancer patients treated with tamoxifen and toremifene, annual cataract rates were found to be 6.8% and 6.2% respectively.…”

Section: Anterior Segment Side Effectsmentioning

confidence: 99%

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Omoti

2006

Pharmacy pract. (Granada Ed. impr.)

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*The increased use of chemotherapeutic agents has resulted in longer cancer patient survival. Consequently the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Ocular toxicity induced by cancer chemotherapy includes a broad spectrum of disorders, reflecting the unique anatomical, physiological and biochemical features of the eye. Understanding the ocular side effects will assist the ophthalmologist and oncologist to recognize them early and intervene before blindness occurs. Anticipation of various treatmentrelated toxicities may also provide the opportunity for pharmacists to develop intervention strategies that could minimize or eliminate an expected side effect. The ophthalmologist should examine patients on anticancer therapy at baseline and three monthly thereafter. The various ocular side effects of anticancer chemotherapeutic agents, tamoxifen, and interferon on the adnexia, anterior segment, posterior segment and neuro-ophthalmic structures were reviewed.

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Section: Anterior Segment Side Effectsmentioning

confidence: 99%

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Omoti

2006

Pharmacy pract. (Granada Ed. impr.)

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“…Estrogens reduce low density lipoprotein (LDL) 1 cholesterol levels and elevate HDL cholesterol levels (2-4), although these beneficial lipid changes may not translate into favorable clinical results (5). Estrogens may also inhibit the development of colon cancer (5), inhibit the development of Alzheimer's disease (6), and inhibit development of cataracts (7,8). The multitude of estrogen responses matches the widespread distribution of estrogen receptors (ERs) throughout numerous organs, with ER␣ expression the highest in uterus, pituitary, kidney, and adrenal gland and ER␤ expression highest in ovary, uterus, bladder, and lung (9).…”

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confidence: 99%

Estrogen Receptor α Regulates Expression of the Orphan Receptor Small Heterodimer Partner

Lai¹,

Harnish²,

Evans³

2003

Journal of Biological Chemistry

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Hormonal status can influence diverse metabolic pathways. Small heterodimer partner (SHP) is an orphan nuclear receptor that can modulate the activity of several transcription factors. Estrogens are here shown to directly induce expression of the SHP in the mouse and rat liver and in human HepG2 cells. SHP is rapidly induced within 2 h following treatment of mice with ethynylestradiol (EE) or the estrogen receptor ␣ (ER␣)-selective compound propyl pyrazole triol (PPT). SHP induction by these estrogens is completely absent in ER␣KO mice. Mutation of the human SHP promoter defined HNF-3, HNF-4, GATA, and AP-1 sites as important for basal activity, whereas EE induction required two distinct elements located between ؊309 and ؊267. One of these elements contains an estrogen response element half-site that bound purified ER␣, and ER␣ with a mutated DNA binding domain was unable to stimulate SHP promoter activity. This ER␣ binding site overlaps the known farnesoid X receptor (FXR) binding site in the SHP promoter, and the combination of EE plus FXR agonists did not produce an additive induction of SHP expression in mice. Surprisingly, induction of SHP by EE did not inhibit expression of the known SHP target genes cholesterol 7␣-hydroxylase (CYP7A1) or sterol 12␣-hydroxylase (CYP8B1). However, the direct regulation of SHP expression may provide a basis for some of the numerous biological effects of estrogens.Estrogens exert biological effects in numerous organs throughout the body. The role of estrogens in reproductive biology, the prevention of postmenopausal hot flushes, and the prevention of postmenopausal osteoporosis are well established (1). Estrogens reduce low density lipoprotein (LDL) 1 cholesterol levels and elevate HDL cholesterol levels (2-4), although these beneficial lipid changes may not translate into favorable clinical results (5). Estrogens may also inhibit the development of colon cancer (5), inhibit the development of Alzheimer's disease (6), and inhibit development of cataracts (7,8). The multitude of estrogen responses matches the widespread distribution of estrogen receptors (ERs) throughout numerous organs, with ER␣ expression the highest in uterus, pituitary, kidney, and adrenal gland and ER␤ expression highest in ovary, uterus, bladder, and lung (9). Although many of these actions of estrogens are due to the classic signaling pathway in which an ER binds to an estrogen response element in the promoter of a gene (10), it is now clear that many actions of estrogens are mediated by interaction of ER with other signaling pathways. For example, estrogens inhibit chronic and acute liver inflammation in the mouse by a mechanism that does not require ER activation of gene expression (11,12). This in vivo activity of ER correlates with the in vitro ability of ER to inhibit NFB signaling (13, 14), likely through a coactivator competition mechanism (15). Similarly, ER can regulate gene expression via interaction with AP-1 response elements (16).An additional mechanism by which ER could influence diverse s...

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“…7 Finally, a prospective chemopreventive trial 3 and a population case-control study found a higher incidence of cataracts, especially in standard or long-term users of chemotherapy. 48 This finding was recently challenged by a new case-control study, 49 although median tamoxifen exposure in this population was only 2.6 years.…”

Section: Discussionmentioning

confidence: 90%

Ocular toxicity during adjuvant chemoendocrine therapy for early breast cancer

Giannì

Panzini

et al. 2005

Cancer

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BACKGROUND Others have reported ocular toxicity after adjuvant chemoendocrine therapy, but this study looked at ocular toxicity in similarly treated patients from large randomized clinical trials. METHODS Information was retrieved on incidence and timing of ocular toxicity from the International Breast Cancer Study Group (IBCSG) database of 4948 eligible patients randomized to receive tamoxifen or toremifene alone or in combination with chemotherapy (either concurrently or sequentially). Case reports of patients with ocular toxicity were evaluated to determine whether ocular toxicity occurred during chemotherapy and/or hormonal therapy. Additional information was obtained from participating institutions for patients in whom ocular toxicity occurred after chemotherapy but during administration of tamoxifen or toremifene. RESULTS Ocular toxicity was reported in 538 of 4948 (10.9%) patients during adjuvant treatment, mainly during chemotherapy. Forty‐five of 4948 (0.9%) patients had ocular toxicity during hormone therapy alone, but only 30 (0.6%) patients had ocular toxicity reported either without receiving any chemotherapy or beyond 3 months after completing chemotherapy and, thus, possibly related to tamoxifen or toremifene. In 3 cases, retinal alterations, without typical aspects of tamoxifen toxicity, were reported; 4 patients had cataract (2 bilateral), 12 impaired visual acuity, 10 ocular irritation, 1 optical neuritis, and the rest had other symptoms. CONCLUSION Ocular toxicity during adjuvant therapy is a common side effect mainly represented by irritative symptoms due to chemotherapy. By contrast, ocular toxicity during hormonal therapy is rare and does not appear to justify a regular program of ocular examination. However, patients should be informed of this rare side effect so that they may seek prompt ophthalmic evaluation for ocular complaints. Cancer 2006. © 2005 American Cancer Society.

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Eye problems in breast cancer patients treated with tamoxifen

Cited by 75 publications

References 6 publications

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Toxicidad ocular de la quimioterapia sistémica anticancerosa

Estrogen Receptor α Regulates Expression of the Orphan Receptor Small Heterodimer Partner

Ocular toxicity during adjuvant chemoendocrine therapy for early breast cancer

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