Suppression of Plasma Estrogen Levels by Letrozole and Anastrozole Is Related to Body Mass Index in Patients With Breast Cancer
Suppression of Plasma Estrogen Levels by Letrozole and Anastrozole Is Related to Body Mass Index in Patients With Breast Cancer
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DOI：
10.1200/jco.2012.42.0273
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发表时间：
2012-08-20
影响因子：
45.3
通讯作者：
Dowsett, Mitch
中科院分区：
文献类型：
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作者：
Folkerd, Elizabeth J.;Dixon, J. Michael;Dowsett, Mitch
目的探讨芳香化酶抑制剂阿那曲唑和来曲唑对绝经后早期雌激素受体(ER)阳性乳腺癌患者血浆雌二醇和硫酸雌酮水平的抑制作用与体重指数(BMI)的关系。最近的研究报道，AI阿纳曲唑在高BMI女性中的疗效低于他莫昔芬。这种高BMI的效应可能是芳香酶抑制减少和血浆雌激素水平降低的结果，可以通过增加阿那曲唑的剂量或使用更有效的人工智能如来曲唑来克服。患者和方法44名绝经后患者接受阿那曲唑(每天1毫克)治疗3个月，然后莱曲唑(每天2.5毫克)治疗3个月或相反顺序，通过高灵敏放射免疫法测定血浆雌二醇和硫酸雌酮水平。结果雌二醇和硫酸雌酮的基线水平与BMI显著相关(r=0.57，P<0.01；r=0.38，P=0.006)。在接受治疗的患者中，体重指数越高，两种AIS患者的雌激素水平越高，但尽管来曲唑有显著意义(雌二醇和硫酸雌酮分别为r=0.35；P=.013和r=0.30；P=.035)，但与阿那曲唑相比没有显著差异。结论AIS、阿那曲唑和来曲唑对绝经后早期ER阳性乳腺癌患者血浆雌二醇和硫酸雌酮水平的抑制与BMI有关。
PurposeTo investigate whether suppression of plasma estradiol and estrone sulfate levels by the aromatase inhibitors (AIs) anastrozole and letrozole is related to body mass index (BMI) in postmenopausal women with early estrogen receptor (ER) -positive breast cancer. Recent studies have reported that the AI anastrozole has lower effectiveness than tamoxifen in women with high BMI. This effect with high BMI might hypothetically be a result of reduced inhibition of aromatase and suppression of plasma estrogen levels and might be overcome by the use of an increased dose of anastrozole or, alternatively, the use of a more potent AI such as letrozole.Patients and MethodsPlasma estradiol and estrone sulfate levels from a highly sensitive radioimmunoassay were available for 44 postmenopausal patients who received anastrozole (1 mg per day) for 3 months followed by letrozole (2.5 mg per day) for 3 months or the opposite sequence. Correlations between the estrogen suppression by each AI and BMI were assessed.ResultsBaseline values of estradiol and estrone sulfate were significantly correlated with BMI (r = 0.57; P < .001, and r = 0.38; P = .006, respectively). Levels of estrogen in patients receiving treatment were greater at higher levels of BMI with both AIs, but although this was significant with letrozole (r = 0.35; P = .013, and r = 0.30; P = .035 for estradiol and estrone sulfate, respectively), it was not with anastrozole. Suppression of both estrogen types was greater with letrozole across the full range of BMIs in this study.ConclusionThe suppressed levels of plasma estradiol and estrone sulfate in postmenopausal women with early ER-positive breast cancer treated with the AIs anastrozole and letrozole are related to BMI.