Naoko Honma1,2, Masujiro Makita3, Shigehira Saji4, Tetuo Mikami5, Hideaki Ogata6, Rie Horii7, Futoshi Akiyama7, Takuji Iwase8, Shinji Ohno8. 1. Department of Pathology, Toho University School of Medicine, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan. naoko.honma@med.toho-u.ac.jp. 2. Department of Pathology, Cancer Institute, Ariake 3-8-31, Koto-ku, Tokyo, 135-8550, Japan. naoko.honma@med.toho-u.ac.jp. 3. Department of Breast Surgery, Nippon Medical School Musashi Kosugi Hospital, Kosugicho 1-396, Nakahara-ku, Kawasaki City, Kanagawa, 211-8533, Japan. 4. Department of Medical Oncology, Fukushima Medical University, Hikariga-oka 1, Fukushima City, Fukushima, 960-1295, Japan. 5. Department of Pathology, Toho University School of Medicine, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan. 6. Department of Breast and Endocrine Surgery, Toho University Omori Medical Center, Omori-Nishi 6-11-1, Ota-ku, Tokyo, 143-8541, Japan. 7. Department of Pathology, Cancer Institute, Ariake 3-8-31, Koto-ku, Tokyo, 135-8550, Japan. 8. Breast Oncology Center, Cancer Institute Hospital, Ariake 3-8-31, Koto-ku, Tokyo, 135-8550, Japan.
Abstract
PURPOSE: To clarify the profile of adverse events from endocrine therapies in older patients. METHODS: We surveyed 15 subjective symptoms including hot flashes, sweating, knuckle stiffness, knee/shoulder joint pain, limb numbness, lethargy, forgetfulness, depressive state, irritated state, genital bleeding, leukorrhea increase, vaginal dryness, bone fracture, and weight gain by a questionnaire among 2044 patients over 55 years old (total number of answered sheets, 8875) and compared the results according to age (56-69 years old vs. ≥ 70 years old) and type of therapy (aromatase inhibitors (AIs) vs. selective estrogen receptor modulators (SERMs)). Among patients 56-69 years old, 6093 and 314 responses were from patients treated with AIs (1477 patients) and SERMs (123 patients), respectively, and 2292 and 176 responses were from those ≥ 70 years old treated with AIs (581 patients) and SERMs (51 patients), respectively. RESULTS: In patients ≥ 70 years old, sweating, knuckle stiffness, knee/shoulder joint pain, limb numbness, and lethargy were significantly more frequent/severe with AIs than with SERMs. In those aged 56-69, knuckle stiffness and vaginal dryness were significantly more frequent with AIs than with SERMs, but the opposite occurred for hot flashes, leukorrhea increase, genital bleeding, and weight gain. CONCLUSIONS: Among patients ≥ 70 years old, many symptoms were significantly more frequent/severe with AIs than with SERMs, compared with those aged 56-69, which suggests a difference in the profile of adverse events according to the type of endocrine therapy and the patient's age. It is important to consider the benefits and risks of each treatment to optimize endocrine therapy for older patients.
PURPOSE: To clarify the profile of adverse events from endocrine therapies in older patients. METHODS: We surveyed 15 subjective symptoms including hot flashes, sweating, knuckle stiffness, knee/shoulder joint pain, limb numbness, lethargy, forgetfulness, depressive state, irritated state, genital bleeding, leukorrhea increase, vaginal dryness, bone fracture, and weight gain by a questionnaire among 2044 patients over 55 years old (total number of answered sheets, 8875) and compared the results according to age (56-69 years old vs. ≥ 70 years old) and type of therapy (aromatase inhibitors (AIs) vs. selective estrogen receptor modulators (SERMs)). Among patients 56-69 years old, 6093 and 314 responses were from patients treated with AIs (1477 patients) and SERMs (123 patients), respectively, and 2292 and 176 responses were from those ≥ 70 years old treated with AIs (581 patients) and SERMs (51 patients), respectively. RESULTS: In patients ≥ 70 years old, sweating, knuckle stiffness, knee/shoulder joint pain, limb numbness, and lethargy were significantly more frequent/severe with AIs than with SERMs. In those aged 56-69, knuckle stiffness and vaginal dryness were significantly more frequent with AIs than with SERMs, but the opposite occurred for hot flashes, leukorrhea increase, genital bleeding, and weight gain. CONCLUSIONS: Among patients ≥ 70 years old, many symptoms were significantly more frequent/severe with AIs than with SERMs, compared with those aged 56-69, which suggests a difference in the profile of adverse events according to the type of endocrine therapy and the patient's age. It is important to consider the benefits and risks of each treatment to optimize endocrine therapy for older patients.
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