Clinical and biomarker predictors of side effects from tamoxifen

Tamoxifen decreases breast cancer recurrence, mortality, and breast cancer risk in high-risk women. Despite these proven benefits, tamoxifen use is often limited due to side effects. We identified predictors of tamoxifen-induced side effects based on clinical variables and serum tamoxifen metabolite...

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Bibliographic Details
Published in:Breast cancer research and treatment 2012-04, Vol.132 (3), p.1107-1118
Main Authors: Lorizio, Wendy, Wu, Alan H. B., Beattie, Mary S., Rugo, Hope, Tchu, Simone, Kerlikowske, Karla, Ziv, Elad
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Hormonal - adverse effects
Antineoplastic Agents, Hormonal - pharmacokinetics
Antineoplastic Agents, Hormonal - therapeutic use
Biological and medical sciences
Body mass index
Breast cancer
Breast Neoplasms - prevention & control
Cancer research
Cancer therapies
Cytochrome P-450 CYP2D6 - genetics
Drug therapy
Epidemiology
Female
Genetic Association Studies
Genotype
Gynecology. Andrology. Obstetrics
Health aspects
Humans
Logistic Models
Maintenance Chemotherapy
Mammary gland diseases
Medical sciences
Medicine
Medicine & Public Health
Menopause
Metabolites
Middle Aged
Mortality
Multivariate Analysis
Neoplasm Recurrence, Local - prevention & control
Oncology
Postmenopausal women
Side effects
Tamoxifen
Tamoxifen - adverse effects
Tamoxifen - pharmacokinetics
Tamoxifen - therapeutic use
Tumors
Young Adult
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Summary:Tamoxifen decreases breast cancer recurrence, mortality, and breast cancer risk in high-risk women. Despite these proven benefits, tamoxifen use is often limited due to side effects. We identified predictors of tamoxifen-induced side effects based on clinical variables and serum tamoxifen metabolite biomarkers in a cross-sectional study of patients taking tamoxifen. We enrolled 241 women and collected data on demographics, tamoxifen use and side effects, as well as potential clinical and serum predictors. We used logistic regression models and adjusted for age, body mass index, ethnicity, education, prior post-menopausal hormone therapy (HT), tamoxifen duration, and endoxifen levels to identify factors associated with side effects. Common tamoxifen attributed side effects were hot flashes (64%), vaginal dryness (35%), sleep problems (36%), weight gain (6%), and depression, irritability or mood swings (6%). In multi-variate models, tamoxifen duration, age, prior post-menopausal HT, and endoxifen levels all predicted side effects. Women who had been on tamoxifen for >12 months were less likely to report side effects (OR 0.15, 95% CI 0.04–0.58) or severe side effects (OR 0.05, 95% CI 0.005–0.58) compared to women on tamoxifen for
ISSN:0167-6806
1573-7217
1573-7217
DOI:10.1007/s10549-011-1893-4