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  4. Modeling Bone mineral density (BMD) evolution in postmenopausal patients treated by letrozole (L), tamoxifen (T) and sequences of T and L (SAKK 21/07)
 
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Titre

Modeling Bone mineral density (BMD) evolution in postmenopausal patients treated by letrozole (L), tamoxifen (T) and sequences of T and L (SAKK 21/07)

Type
poster de conférence/colloque
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Série
Journal of Clinical Oncology
Auteur(s)
Zaman, K.
Auteure/Auteur
Thürlimann, B.
Auteure/Auteur
Huober, J.
Auteure/Auteur
Schönenberger, A.
Auteure/Auteur
Pagani, O.
Auteure/Auteur
Lüthi, J.
Auteure/Auteur
Simcock, M.
Auteure/Auteur
Giobbie-Hurder, A.
Auteure/Auteur
Genton, C.
Auteure/Auteur
Aebi, S.
Auteure/Auteur
Groupes de travail
on behalf of the Swiss Group for Clinical Cancer Research (SAKK).
Liens vers les personnes
Dosne, Philippe  
Lüthi, Jeanine  
Liens vers les unités
Centre pluridiscip. d'oncologie clinique  
Titre du livre ou conférence/colloque
2009 ASCO Annual Meeting
Adresse
Orlando, Florida, May 29 - June 2, 2009
ISBN
1527-7755
Statut éditorial
Publié
Date de publication
2009
Volume
27
Première page
545
Langue
anglais
Notes
Background: Osteoporosis and fractures are long term complications of aromatase inhibitor use in the adjuvant therapy of breast cancer. Early detection of patients (pts) at risk of treatment-induced osteoporosis may allow preventive therapy and selection of the most appropriate endocrine therapy. We developed a statistical model describing the evolution of BMD in pts treated with T, L and sequences of T and L. Methods: Available dual-energy x-ray absorptiometry exams (DXA) of pts treated in trial BIG 1-98 were retrospectively collected from Swiss centers. Treatment arms: A) T for 5 years; B) L for 5 years; C) 2 years of T followed by 3 years of L; and D) 2 years of L followed by 3 years of T. Pts without DXA were used as a control for detecting selection bias. A repeated measures model using the first-order autoregressive covariance structure to allow for different times between DXA was used to model BMD (g/cm2) since trial randomisation. Prospectively defined covariates were considered as fixed effects in a multivariable model using an intention to treat analysis. Covariates at trial randomization were: age, height, weight, race, known osteoporosis, tobacco use, prior bone fracture, prior hormone replacement therapy (HRT), bisphosphonate use and previous neo-/adjuvant chemotherapy (ChT). Results: A total of 247 out of 546 pts had between 1 and 5 DXA; a total of 576 DXA were collected. Arm A contained 67 pts, B 63 pts, C 55 pts and D 62 pts. Median follow-up was 5.8 years. Factors correlated with BMD in the multivariate analysis were weight (0.003/kg, p < 0.0001), height (0.003/cm, p = 0.0083), osteoporosis (-0.130, p < 0.0001), tobacco (current / previously vs. never: -0.057, p = 0.0011 / -0.042, p = 0.0798), previous HRT (0.030, p = 0.0244), ChT (0.032, p = 0.0174), time since endocrine therapy start (-0.009/year, p = 0.0164) and treatment arm (B / C / D vs. A: -0.068, p = 0.0002 / -0.091, p < 0.0001 / -0.064, p = 0.003). Conclusions: Our statistical model describes the BMD evolution for pts treated with L and/or T. All treatment regimens affect BMD. Contrary to expectation, the switch schedule T followed by L does not seem to result in better bone protection compared to L monotherapy
PID Serval
serval:BIB_994F798BBC88
Permalien
https://iris.unil.ch/handle/iris/176138
Date de création
2009-06-11T09:46:47.582Z
Date de création dans IRIS
2025-05-21T00:37:01Z
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