Document Detail


Effect of a switch of aromatase inhibitors on musculoskeletal symptoms in postmenopausal women with hormone-receptor-positive breast cancer: the ATOLL (articular tolerance of letrozole) study.
MedLine Citation:
PMID:  20035381     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of the present study was to evaluate the effect of the switch of aromatase inhibitors (AIs) on musculoskeletal symptoms in postmenopausal women with hormone-receptor-positive breast cancer. This was a 6-month, prospective, non-randomized, multicenter study. Patients who had discontinued anastrozole due to musculoskeletal symptoms were eligible to participate in this study, and received letrozole, which was initiated 1 month after anastrozole discontinuation. Musculoskeletal symptoms were systematically assessed for severity, location of the symptoms, presence of swelling and of morning stiffness by the oncologist patients when patients stopped taking their anastrozole, 1 month after the discontinuation of anastrozole, and 1, 3, and 6 months after initiating the letrozole therapy. The primary endpoint was the percentage of patients who discontinued letrozole due to the severe musculoskeletal symptoms. After switching from anastrozole therapy, and at the end of the 6-month letrozole treatment, 128 (71.5%) out of 179 patients (61.3 +/- 8.4 years) continued with letrozole. Fifty-one patients (28.5%) discontinued treatment due to severe joint pain. At the end of the 6-month, 116 patients (73.9%) had arthralgia, 33 (21.0%) myalgia, 25 (15.9%) arthritis, 22 (14.0%) tendinitis, and 20 (12.7%) polyalgic syndrome. Bivariate analysis of the factors associated with letrozole discontinuation showed that the duration of a prior anastrozole treatment was a significant predictor (P = 0.04). This study shows that in patients intolerant to one AI, switching to another agent allows a higher proportion of patients to continue the therapy and maximize hormonal adjuvant therapy and disease outcome benefits.
Authors:
Karine Briot; Mich?le Tubiana-Hulin; Laurent Bastit; Ioana Kloos; Christian Roux
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2009-12-25
Journal Detail:
Title:  Breast cancer research and treatment     Volume:  120     ISSN:  1573-7217     ISO Abbreviation:  Breast Cancer Res. Treat.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111104     Medline TA:  Breast Cancer Res Treat     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  127-34     Citation Subset:  IM    
Affiliation:
Rheumatology Department, Cochin Hospital, Rheumatology Department, Paris Descartes University, 27 rue Faubourg Saint Jacques, 75014, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents, Hormonal / adverse effects*
Aromatase Inhibitors / adverse effects*
Breast Neoplasms / drug therapy*
Female
Humans
Middle Aged
Musculoskeletal Diseases / chemically induced*
Neoplasms, Hormone-Dependent / drug therapy*
Nitriles / adverse effects,  therapeutic use*
Postmenopause
Triazoles / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Aromatase Inhibitors; 0/Nitriles; 0/Triazoles; 112809-51-5/letrozole; 120511-73-1/anastrozole

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