Lipid changes in breast cancer patients on exemestane treatment: final results of the TEAM Greek substudy

Background: The Greek substudy of the Tamoxifen and ExemestaneAdjuvant Multicenter International trial compared the effectof exemestane on the lipid profile of postmenopausal, breastcancer patients to that of tamoxifen in the adjuvant setting. Patients and methods: Lipidemic profile changes were studiedin 142 postmenopausal patients randomized to receive eitheradjuvant exemestane (n = 77) or tamoxifen (n = 65). Total cholesterol(TC), high-density lipoprotein (HDL), low-density lipoprotein(LDL) and serum triglyceride (TRG) levels were measured at baselineand then every 3 months for the first 12 months of treatmentand at 18 and 24 months. Results: A trend for a reduction in TC was found in both treatmentarms; however, TC and LDL levels were consistently and significantlydecreased in tamoxifen arm only. The mean HDL level was higherfor the tamoxifen arm compared with the exemestane arm acrosstime. No significant trend was detected throughout the studyperiod on TRG levels on either arm. Conclusions: Unlike tamoxifen's beneficial effect on TC andLDL levels, exemestane appears to have a neutral effect on lipidemicprofile of postmenopausal, breast cancer patients. These dataoffer additional information with regard to the safety and tolerabilityof exemestane treatment in the adjuvant setting. Key words: aromatase inhibitors, breast cancer, cholesterol, exemestane, lipids, tamoxifen, TEAM trial Received for publication May 4, 2008. Revision received July 3, 2008. Accepted for publication July 4, 2008.