Elsevier

The Breast

Volume 18, Issue 3, June 2009, Pages 159-164
The Breast

Original article
The effect of exemestane or tamoxifen on markers of bone turnover: Results of a German sub-study of the Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial

https://doi.org/10.1016/j.breast.2009.03.003Get rights and content
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open access

Abstract

Adjuvant treatment of breast cancer with aromatase inhibitors has been associated with increased bone loss. In this study, postmenopausal patients with oestrogen receptor positive breast cancer were randomised to exemestane for 5 years or tamoxifen for 2–2.5 years, followed by exemestane for 2–2.5 years. Levels of bone formation markers (bone specific alkaline phosphatase, amino terminal propeptide of type I procollagen, osteocalcin), and the bone resorption marker (carboxyterminal crosslinked telopeptide of type I collagen), were assessed at baseline and after 3, 6 and 12 months of treatment.

Exemestane (n = 78) resulted in increases from baseline in all bone turnover marker levels at all timepoints. In contrast, levels of all bone marker turnovers decreased with tamoxifen (n = 83). Differences between tamoxifen and exemestane were statistically significant for all bone turnover markers at all timepoints.

In conclusion, exemestane results in increases in markers of bone formation and resorption, while decreases are observed with tamoxifen.

Keywords

Aromatase inhibitor
Bone turnover
Early breast cancer
Exemestane
Osteoporosis
Fractures

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