Toremifene as an Adjuvant Hormone Therapy for Estrogen Receptor Positive early Breast Cancer: Therapeutic Efficacy and Effect on Endometrium

Heon-Kyun Ha; Wonshik Han; Eunyoung Ko; So Young Kang; Jong Won Lee; Jihyoung Cho; So-Youn Jung; Eun-Kyu Kim; Seung Keun Oh; Yeo-Kyu Youn; Dong-Young Noh

doi:10.4048/jbc.2007.10.4.258

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Ha, Han, Ko, Kang, Lee, Cho, Jung, Kim, Oh, Youn, and Noh: Toremifene as an Adjuvant Hormone Therapy for Estrogen Receptor Positive early Breast Cancer: Therapeutic Efficacy and Effect on Endometrium

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2007; 10(4): 258-262.

Published online: 31 December 2007

DOI: https://doi.org/10.4048/jbc.2007.10.4.258

Toremifene as an Adjuvant Hormone Therapy for Estrogen Receptor Positive early Breast Cancer: Therapeutic Efficacy and Effect on Endometrium

Heon-Kyun Ha, Wonshik Han, Eunyoung Ko, So Young Kang¹, Jong Won Lee, Jihyoung Cho, So-Youn Jung, Eun-Kyu Kim, Seung Keun Oh, Yeo-Kyu Youn, Dong-Young Noh

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

¹Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

dynoh@plaza.snu.ac.kr

Received 28 September 2007 Accepted 30 October 2007

Abstract

Purpose

This study was conducted to evaluate the use of toremifene as an adjuvant hormonal therapy for estrogen recepter (ER) positive early breast cancer patients in terms of therapeutic efficacy and effect on endometrium as compared with tamoxifen.

Methods

Between January 2001 and December 2003, 451 patients with stage 0, I and II breast cancer, received adjuvant hormone therapy that consisted of either tamoxifen (N=387) or toremifene (N=64). The recurrence rate and survival rate were compared between two groups and the incidence of of endometrial event was evaluated in 273 of the patients.

Results

The median follow up period was 57 months and the median hormonal therapy period was 51 months. During the follow up period, there were 3 (2.0%) recurrence in the stage I tamoxifen group, 19 recurrences (8.7%) and 3 deaths (1.4%) in the stage II tamoxifen group (n=219), however there were no instances of recurrence or death in all of the toremifene group. In addition, endometrial cancer developed in 2 patients in the tamoxifen group, but in no patients in toremifene group during the follow up period. Further 21 of the patients who began treatment using tamoxifen changed to toremifene due to adverse side effects. The toremifene was well tolerated by 15 of the patients that changed treatment regimes.

Conclusion

Toremifene was found to be as effective and safe as tamoxifen, when used as an adjuvant hormonal therapeutic agent in ER-positive early breast cancer, therefore toremifene may be a good option in place of tamoxifen for patients who are experiencing adverse effects as a result of tamoxifen treatment.

Keywords: Breast cancer, Tamoxifen, Toremifene, Endometrial cancer

Figures and Tables

Fig 1

Disease free survival of tamoxifen and toremifene in stage I (A) and stage II (B).

Fig 2

Overall survival of tamoxifen and toremifene.

Table 1

Patients characteristics of tamoxifen and toremifene group

BMI=Body Mass Index, body weigh (kg)/height² (m²).

Table 2

Recurrence and death rate of tamoxifen and toremifene group in early stage

DCIS=ductal carcinoma in situ. ^*Log-rank test.

Table 3

Cox model and logistic regression model of recurrence for adjusting confounding variables between tamoxifen and toremifene

^*Wald chi-square statistics.

Table 4

Cox model and logistic regression model of death for adjusting confounding variables between tamoxifen and toremifene

^*Wald chi-square statistics.

Table 5

Endometrial abnormality found during medication

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