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Influence of hormone replacement therapy on tamoxifen-induced vasomotor symptoms.
J Clin Oncol. 2006 Aug 20; 24(24):3991-6.JC

Abstract

PURPOSE

Tamoxifen is an effective drug, but its role in prevention is limited by its adverse effect profile. Non-life-threatening adverse effects, such as vasomotor symptoms, have an important influence in its use for prevention. Vasomotor symptoms were evaluated according to follow-up time, severity, and use of hormone replacement therapy (HRT) in a retrospective analysis.

PATIENTS AND METHODS

In the International Breast Cancer Intervention Study-I study, 7,154 women at increased risk of breast cancer were randomly assigned to either tamoxifen 20 mg/d or placebo for 5 years. Women gave detailed information on any vasomotor symptoms at each 6-month follow-up visit.

RESULTS

Hot flushes were reported more often in the tamoxifen group than in the placebo group (70.6% v 57.1%, respectively; odds ratio, 1.80; 95% CI, 1.63 to 1.99). Severe hot flushes were more strongly related to tamoxifen. In the tamoxifen arm, more women taking HRT at entry experienced hot flushes in the first 6 months than those who did not take HRT (60.8% v 49.2%, respectively; P = .09). In contrast, women on placebo taking HRT at entry experienced fewer hot flushes than women who stopped HRT (22.9% v 34.3%, respectively; P = .03). Furthermore, for women who first began HRT in the first 6 months of the trial compared with women who did not begin HRT, HRT seemed to be much more effective in controlling hot flushes in months 6 to 12 in the placebo arm (47.9% v 20.4%, respectively) than in the tamoxifen arm (51.4% v 39.0%, respectively).

CONCLUSION

HRT use at entry or during the trial was not effective in alleviating hot flushes for women in the tamoxifen arm. Our retrospective study suggests that estrogen-based HRT has limited effectiveness among women receiving tamoxifen.

Authors+Show Affiliations

Cancer Research UK, Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16921052

Citation

Sestak, Ivana, et al. "Influence of Hormone Replacement Therapy On Tamoxifen-induced Vasomotor Symptoms." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 24, no. 24, 2006, pp. 3991-6.
Sestak I, Kealy R, Edwards R, et al. Influence of hormone replacement therapy on tamoxifen-induced vasomotor symptoms. J Clin Oncol. 2006;24(24):3991-6.
Sestak, I., Kealy, R., Edwards, R., Forbes, J., & Cuzick, J. (2006). Influence of hormone replacement therapy on tamoxifen-induced vasomotor symptoms. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 24(24), 3991-6.
Sestak I, et al. Influence of Hormone Replacement Therapy On Tamoxifen-induced Vasomotor Symptoms. J Clin Oncol. 2006 Aug 20;24(24):3991-6. PubMed PMID: 16921052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of hormone replacement therapy on tamoxifen-induced vasomotor symptoms. AU - Sestak,Ivana, AU - Kealy,Roseann, AU - Edwards,Robert, AU - Forbes,John, AU - Cuzick,Jack, PY - 2006/8/22/pubmed PY - 2006/9/13/medline PY - 2006/8/22/entrez SP - 3991 EP - 6 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 24 IS - 24 N2 - PURPOSE: Tamoxifen is an effective drug, but its role in prevention is limited by its adverse effect profile. Non-life-threatening adverse effects, such as vasomotor symptoms, have an important influence in its use for prevention. Vasomotor symptoms were evaluated according to follow-up time, severity, and use of hormone replacement therapy (HRT) in a retrospective analysis. PATIENTS AND METHODS: In the International Breast Cancer Intervention Study-I study, 7,154 women at increased risk of breast cancer were randomly assigned to either tamoxifen 20 mg/d or placebo for 5 years. Women gave detailed information on any vasomotor symptoms at each 6-month follow-up visit. RESULTS: Hot flushes were reported more often in the tamoxifen group than in the placebo group (70.6% v 57.1%, respectively; odds ratio, 1.80; 95% CI, 1.63 to 1.99). Severe hot flushes were more strongly related to tamoxifen. In the tamoxifen arm, more women taking HRT at entry experienced hot flushes in the first 6 months than those who did not take HRT (60.8% v 49.2%, respectively; P = .09). In contrast, women on placebo taking HRT at entry experienced fewer hot flushes than women who stopped HRT (22.9% v 34.3%, respectively; P = .03). Furthermore, for women who first began HRT in the first 6 months of the trial compared with women who did not begin HRT, HRT seemed to be much more effective in controlling hot flushes in months 6 to 12 in the placebo arm (47.9% v 20.4%, respectively) than in the tamoxifen arm (51.4% v 39.0%, respectively). CONCLUSION: HRT use at entry or during the trial was not effective in alleviating hot flushes for women in the tamoxifen arm. Our retrospective study suggests that estrogen-based HRT has limited effectiveness among women receiving tamoxifen. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/16921052/Influence_of_hormone_replacement_therapy_on_tamoxifen_induced_vasomotor_symptoms_ L2 - https://ascopubs.org/doi/10.1200/JCO.2005.04.3745?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -