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01-07-2012 | Clinical Trial

Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer

Authors: Ivana Sestak, Michelle Harvie, Anthony Howell, John F. Forbes, Mitch Dowsett, Jack Cuzick

Published in: Breast Cancer Research and Treatment | Issue 2/2012

Abstract

Weight gain is commonly reported by breast cancer patients on tamoxifen or aromatase inhibitors. Since weight gain may impact on outcome and compliance we have prospectively assessed the effects of these agents on weight change in three randomised trials for the treatment or prevention of breast cancer. Data on weight change in postmenopausal women from three large clinical trials investigating endocrine therapy for the treatment or prevention of breast cancer were analysed (ATAC, IBIS-I and IBIS-II). In the IBIS-I study, mean weight change on tamoxifen was +0.1 kg (SD 0.1) compared with +0.3 kg (SD 0.1) in women taking the placebo (P = 0.3) between baseline and 12 months of follow-up. In the IBIS-II trial, no statistically significant difference was found between anastrozole and placebo after 12 months of follow-up [+0.8 kg (SD 5.3) vs. +0.5 kg (SD 7.4), P = 0.5]. In the ATAC trial, no statistically significant differences in weight gain between anastrozole and tamoxifen were found after 12 months of follow-up [+1.4 kg (SD 3.9) vs. +1.5 kg (SD 4.0), P = 0.4]. Significant baseline predictors for gaining more than 5 kg of weight after 12 months of follow-up were: being younger than 60 years old, smoking and mastectomy. All three trials demonstrate that weight gain occurs primarily within the first 12 months of active treatment in a subset of patients. In the prevention trials, weight gain does not differ between anastrozole, tamoxifen and placebo and also did not differ between anastrozole and tamoxifen in the treatment trial.

Tredan O, Bajard A, Meunier A, Roux P, Fiorletta I, Gargi T, Bachelot T, Guastalla JP, Lallemand Y, Faure C, Perol D, Bachmann P (2010) Body weight change in women receiving adjuvant chemotherapy for breast cancer: a French prospective study. Clin Nutr 29(2):187–191

Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, Rock CL, Pierce JP (2007) Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res Treat 105(2):177–186PubMedCrossRef

Harvie MN, Campbell IT, Baildam A, Howell A (2004) Energy balance in early breast cancer patients receiving adjuvant chemotherapy. Breast Cancer Res Treat 83(3):201–210PubMedCrossRef

Goodwin PJ, Ennis M, Pritchard KI, McCready D, Koo J, Sidlofsky S, Trudeau M, Hood N, Redwood S (1999) Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 17(1):120–129PubMed

Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, Ballard-Barbash R (2005) Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol 23(4):774–782PubMedCrossRef

Monnin S, Schiller MR, Sachs L, Smith AM (1993) Nutritional concerns of women with breast cancer. J Cancer Educ 8(1):63–69PubMedCrossRef

Carlini P, Bria E, Giannarelli D, Ferretti G, Felici A, Papaldo P, Fabi A, Nistico C, Di Cosimo S, Ruggeri EM, Milella M, Mottolese M, Terzoli E, Cognetti F (2005) New aromatase inhibitors as second-line endocrine therapy in postmenopausal patients with metastatic breast carcinoma: a pooled analysis of the randomized trials. Cancer 104(7):1335–1342PubMedCrossRef

Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J (2010) Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol 28(21):3411–3415PubMedCrossRef

Pfeiler G, Konigsberg R, Fesl C, Mlineritsch B, Stoeger H, Singer CF, Postlberger S, Steger GG, Seifert M, Dubsky P, Taucher S, Samonigg H, Bjelic-Radisic V, Greil R, Marth C, Gnant M (2010) Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: an analysis of the prospective ABCSG-12 trial. J Clin Oncol 29(19): 2653–2659

10.

Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23(7):1370–1378PubMedCrossRef

11.

Caan BJ, Kwan ML, Hartzell G, Castillo A, Slattery ML, Sternfeld B, Weltzien E (2008) Pre-diagnosis body mass index, post-diagnosis weight change, and prognosis among women with early stage breast cancer. Cancer Causes Control 19(10):1319–1328PubMedCrossRef

12.

Goodwin PJ, Panzarella T, Boyd NF (1988) Weight gain in women with localized breast cancer—a descriptive study. Breast Cancer Res Treat 11(1):59–66PubMedCrossRef

13.

Carmichael AR (2006) Obesity and prognosis of breast cancer. Obes Rev 7(4):333–340PubMedCrossRef

14.

Nichols HB, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Holmes MD, Bersch AJ, Holick CN, Hampton JM, Stampfer MJ, Willett WC, Newcomb PA (2009) Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev 18(5):1403–1409PubMedCrossRef

15.

Hoskin PJ, Ashley S, Yarnold JR (1992) Weight gain after primary surgery for breast cancer—effect of tamoxifen. Breast Cancer Res Treat 22(2):129–132PubMedCrossRef

16.

Kumar NB, Allen K, Cantor A, Cox CE, Greenberg H, Shah S, Lyman GH (1997) Weight gain associated with adjuvant tamoxifen therapy in stage I and II breast cancer: fact or artifact? Breast Cancer Res Treat 44(2):135–143PubMedCrossRef

17.

Fisher B, Dignam J, Bryant J, DeCillis A, Wickerham DL, Wolmark N, Costantino J, Redmond C, Fisher ER, Bowman DM, Deschenes L, Dimitrov NV, Margolese RG, Robidoux A, Shibata H, Terz J, Paterson AH, Feldman MI, Farrar W, Evans J, Lickley HL (1996) Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors. J Natl Cancer Inst 88(21):1529–1542PubMedCrossRef

18.

Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B (1999) Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Clin Oncol 17(9):2659–2669PubMed

19.

Powles T, Eeles R, Ashley S, Easton D, Chang J, Dowsett M, Tidy A, Viggers J, Davey J (1998) Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trial. Lancet 352(9122):98–101PubMedCrossRef

20.

Baum M, Buzdar A, Cuzick J, Forbes J, Houghton J, Howell A, Sahmoud T (2003) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer 98(9):1802–1810PubMedCrossRef

21.

Francini G, Petrioli R, Montagnani A, Cadirni A, Campagna S, Francini E, Gonnelli S (2006) Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids. Br J Cancer 95(2):153–158PubMedCrossRef

22.

Cuzick J (2008) IBIS II: a breast cancer prevention trial in postmenopausal women using the aromatase inhibitor anastrozole. Expert Rev Anticancer Ther 8(9):1377–1385PubMedCrossRef

23.

Cuzick J (2008) Chemoprevention of breast cancer. Breast Cancer 15(1):10–16PubMedCrossRef

24.

Fallowfield L (2008) There’s many a slip twixt cup and lip: adherence issues in cancer therapy. Nat Clin Pract Oncol 5(3):118–119PubMedCrossRef

25.

Vrieling A, Buck K, Kaaks R, Chang-Claude J (2010) Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat 123(3):641–649

26.

Vance V, Mourtzakis M, McCargar L, Hanning R (2010) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12(4): 282–294

27.

Cuzick J, Forbes J, Edwards R, Baum M, Cawthorn S, Coates A, Hamed A, Howell A, Powles T (2002) First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial. Lancet 360(9336):817–824PubMedCrossRef

28.

Baum M, Budzar AU, Cuzick J, Forbes J, Houghton JH, Klijn JG, Sahmoud T (2002) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 359(9324):2131–2139PubMedCrossRef

29.

Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M (2008) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol 9(1):45–53PubMedCrossRef

30.

Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, Hoctin-Boes G, Houghton J, Locker GY, Tobias JS (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365(9453):60–62PubMedCrossRef

31.

Powles TJ, Ashley S, Tidy VA, Smith IE, Dowsett M (2006) 20 year follow-up of the Royal Marsden tamoxifen breast cancer prevention trials. In: San Antonio Breast Cancer Symposium. San Antonio

32.

Levine EG, Raczynski JM, Carpenter JT (1991) Weight gain with breast cancer adjuvant treatment. Cancer 67(7):1954–1959PubMedCrossRef

33.

Goodwin P, Esplen MJ, Butler K, Winocur J, Pritchard K, Brazel S, Gao J, Miller A (1998) Multidisciplinary weight management in locoregional breast cancer: results of a phase II study. Breast Cancer Res Treat 48(1):53–64PubMedCrossRef

34.

Knobf MT (1986) Physical and psychologic distress associated with adjuvant chemotherapy in women with breast cancer. J Clin Oncol 4(5):678–684PubMed

35.

DeGeorge D, Gray JJ, Fetting JH, Rolls BJ (1990) Weight gain in patients with breast cancer receiving adjuvant treatment as a function of restraint, disinhibition, and hunger. Oncol Nurs Forum 17(3 Suppl):23–28 discussion 28-30PubMed

36.

Winningham ML, Nail LM, Burke MB, Brophy L, Cimprich B, Jones LS, Pickard-Holley S, Rhodes V, St Pierre B, Beck S et al (1994) Fatigue and the cancer experience: the state of the knowledge. Oncol Nurs Forum 21(1):23–36PubMed

37.

Svendsen OL, Hassager C, Christiansen C (1995) Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metabolism 44(3):369–373PubMedCrossRef

38.

Wing RR (1992) Obesity and weight gain during adulthood: a health problem for United States women. Womens Health Issues 2(2):114–120 discussion 120-2PubMedCrossRef

39.

Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga PL (1991) Weight gain at the time of menopause. Arch Intern Med 151(1):97–102PubMedCrossRef

40.

Beaver ME, Matheny KE, Roberts DB, Myers JN (2001) Predictors of weight loss during radiation therapy. Otolaryngol Head Neck Surg 125(6):645–648PubMedCrossRef

41.

Nourissat A, Bairati I, Samson E, Fortin A, Gelinas M, Nabid A, Brochet F, Tetu B, Meyer F (2010) Predictors of weight loss during radiotherapy in patients with stage I or II head and neck cancer. Cancer 116(9):2275–2283

42.

Langius JA, Doornaert P, Spreeuwenberg MD, Langendijk JA, Leemans CR, Schueren MA (2010) Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiother Oncol 97(1):80–85

43.

Kulkarni SK, Kaur G (2001) Pharmacodynamics of drug-induced weight gain. Drugs Today (Barc) 37(8):559–571CrossRef

44.

Hauber AB, Mohamed AF, Johnson FR, Falvey H (2009) Treatment preferences and medication adherence of people with Type 2 diabetes using oral glucose-lowering agents. Diabet Med 26(4):416–424PubMedCrossRef

45.

Harvie M, Howell T (2005) Need for weight management among postmenopausal early breast cancer patients receiving adjuvant endocrine therapy. Womens Health (Lond Engl) 1(2):205–222CrossRef

Title: Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer
Authors: Ivana Sestak
Michelle Harvie
Anthony Howell
John F. Forbes
Mitch Dowsett
Jack Cuzick
Publication date: 01-07-2012
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2012
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-012-2085-6

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