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Cholesterol, cholesterol-lowering medication use, and breast cancer outcome in the BIG 1-98 study

Borgquist, Signe, (författare)
Lunds universitet, Lund University, Medicinska fakulteten, Faculty of Medicine, Institutionen för kliniska vetenskaper, Lund, Department of Clinical Sciences, Lund, Sektion I-II, Division I-II, Kliniska Vetenskaper, Helsingborg, Clinical Sciences, Helsingborg, Sektion V, Division V, Onkologi och Patologi, Kampradlab, Oncology and Pathology, Kamprad Lab, Strategiska forskningsområden, Strategic Research Areas, BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation, BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
Giobbie-Hurder, Anita, (författare)
Dana-Farber Cancer Institute
Ahern, Thomas P, (författare)
University of Vermont
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Garber, Judy E, (författare)
Harvard Medical School
Colleoni, Marco, (författare)
European Institute of Oncology
Láng, István, (författare)
National Institute of Oncology, Budapest
Debled, Marc, (författare)
Institut Bergoníe
Ejlertsen, Bent, (författare)
Copenhagen University Hospital
Von Moos, Roger, (författare)
Cantonal Hospital Graubunden
Smith, Ian E., (författare)
Royal Marsden Hospital
Coates, Alan S., (författare)
University of Sydney
Goldhirsch, Aron, (författare)
European Institute of Oncology
Rabaglio, Manuela, (författare)
Bern University Hospital
Price, Karen N., (författare)
Frontier Science and Technology Research Foundation
Gelber, Richard D., (författare)
Frontier Science and Technology Research Foundation
Regan, Meredith M., (författare)
Frontier Science and Technology Research Foundation
Thürlimann, Beat, (författare)
Breast Center St. Gallen
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Lunds universitet Onkologi och Patologi, Kampradlab. (creator_code:org_t)
Lunds universitet BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation. (creator_code:org_t)
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Lunds universitet Kliniska Vetenskaper, Helsingborg. (creator_code:org_t)
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Engelska 10 s.
Ingår i: Journal of Clinical Oncology. - American Society of Clinical Oncology. - 0732-183X. ; 35:11, s. 1179-1188
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • Purpose Cholesterol-lowering medication (CLM) has been reported to have a role in preventing breast cancer recurrence. CLM may attenuate signaling through the estrogen receptor by reducing levels of the estrogenic cholesterol metabolite 27-hydroxycholesterol. The impact of endocrine treatment on cholesterol levels and hypercholesterolemia per se may counteract the intended effect of aromatase inhibitors. Patients and Methods The Breast International Group (BIG) conducted a randomized, phase III, double-blind trial, BIG 1-98, which enrolled 8,010 postmenopausal women with early-stage, hormone receptor-positive invasive breast cancer from 1998 to 2003. Systemic levels of total cholesterol and use of CLM were measured at study entry and every 6 months up to 5.5 years. Cumulative incidence functions were used to describe the initiation of CLM in the presence of competing risks. Marginal structural Cox proportional hazards modeling investigated the relationships between initiation of CLM during endocrine therapy and outcome. Three time-to-event end points were considered: disease-freesurvival, breast cancer-free interval, and distant recurrence-free interval. Results Cholesterol levels were reduced during tamoxifen therapy. Of 789 patients who initiated CLM during endocrine therapy, the majority came from the letrozole monotherapy arm (n = 318), followed by sequential tamoxifen-letrozole (n = 189), letrozole-tamoxifen (n = 176), and tamoxifen monotherapy (n = 106). Initiation of CLM during endocrine therapy was related to improved disease-free-survival (hazard ratio [HR], 0.79; 95% CI, 0.66 to 0.95; P = .01), breast cancer-free interval (HR, 0.76; 95% CI, 0.60 to 0.97; P = .02), and distant recurrence-free interval (HR, 0.74; 95% CI, 0.56 to 0.97; P = .03). Conclusion Cholesterol-lowering medication during adjuvant endocrine therapy may have a role in preventing breast cancer recurrence in hormone receptor-positive early-stage breast cancer. We recommend that these observational results be addressed in prospective randomized trials.


MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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