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
Liens vers les unités
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
Date de création
2009-06-11T09:46:47.582Z
Date de création dans IRIS
2025-05-21T00:37:01Z