Show simple item record

dc.contributor.authorBorgquist, S
dc.contributor.authorGiobbie-Hurder, A
dc.contributor.authorAhern, TP
dc.contributor.authorGarber, JE
dc.contributor.authorColleoni, M
dc.contributor.authorLáng, I
dc.contributor.authorDebled, M
dc.contributor.authorEjlertsen, B
dc.contributor.authorvon Moos, R
dc.contributor.authorSmith, I
dc.contributor.authorCoates, AS
dc.contributor.authorGoldhirsch, A
dc.contributor.authorRabaglio, M
dc.contributor.authorPrice, KN
dc.contributor.authorGelber, RD
dc.contributor.authorRegan, MM
dc.contributor.authorThürlimann, B
dc.date.accessioned2018-03-05T15:00:24Z
dc.date.issued2017-04
dc.identifier.citationJournal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017, 35 (11), pp. 1179 - 1188
dc.identifier.issn0732-183X
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1548
dc.identifier.eissn1527-7755
dc.identifier.doi10.1200/jco.2016.70.3116
dc.description.abstractPurpose 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-free-survival, 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.
dc.formatPrint-Electronic
dc.format.extent1179 - 1188
dc.languageeng
dc.language.isoeng
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectNeoplasm Recurrence, Local
dc.subjectHypercholesterolemia
dc.subjectTamoxifen
dc.subjectNitriles
dc.subjectTriazoles
dc.subjectCholesterol
dc.subjectReceptors, Estrogen
dc.subjectReceptors, Progesterone
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectAnticholesteremic Agents
dc.subjectDisease-Free Survival
dc.subjectChemotherapy, Adjuvant
dc.subjectRadiotherapy, Adjuvant
dc.subjectMastectomy, Segmental
dc.subjectProportional Hazards Models
dc.subjectFollow-Up Studies
dc.subjectDouble-Blind Method
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectLetrozole
dc.titleCholesterol, Cholesterol-Lowering Medication Use, and Breast Cancer Outcome in the BIG 1-98 Study.
dc.typeJournal Article
rioxxterms.versionofrecord10.1200/jco.2016.70.3116
rioxxterms.licenseref.startdate2017-04
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of clinical oncology : official journal of the American Society of Clinical Oncology
pubs.issue11
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume35
pubs.embargo.termsNot known
icr.researchteamMedicine (RMH Smith Cunningham)en_US
dc.contributor.icrauthorSmith, Ianen
dc.contributor.icrauthorMarsden,en


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record