Effects Of Tamoxifen (TAM) And Toremifene (TOR) On Hepatic Function And Serum Lipids In Patients With Breast Carcinoma

Tamoxifen is the most frequent drug used in the breast carcinoma.In 1971 Tamoxifen was in clinical trial in Europe and in 1977 it was qualificated for treatment on the menopausal breast carcinoma with metastasis.Now Tamoxifen has used in every stage breast carcinoma irrespective of the menopause situation.Tamoxifen competitively inhibit the combination of estrogen with its receptor.However,this estrogenic function in endometrium and coagulation system can not be simply explained by inhibition of the estrogenic receptor.This function was also present in the bone and lipid metabolism,especially in the bone density and serum lipid level. Tamoxifen as well as its analogs is not a simple antiestrogen,it is selective estrogen receptor modulators(SERMs),such as Toremifene.Toremifene is another drug of SERMs.It started clinical treatment in breast carcinoma in 1995,which has the similar molecular constitution,mechanism and activity.Generally,Tamoxifen and Toremifene was kept administrating for 2～5 years. Their effects on hepatic function and serum lipids were seldom reported.In this study, we analyze the effects of Tamoxifen and Toremifene on hepatic function and serum lipids in patients with breast carcinoma in order to clarify the differences between two drugs and to direct in the clinic.Objects and methodsPatients were qualificated by(1)patients were admitted in Sir Run Run Show Hospital,accepted breast surgery and verificated of breast carcinoma by pathology. (2)patients accept endocrine therapy after the end of chemotherapy if needed.(3) ECOG grade 0～1,without metastasis and thrombus,coronary heart disease, disfunction of liver,kidney and bone.(4)Be followed up by Sir Run Run Show Hospital.170 patients were randomly divided to three groups.One group was given Toremifene 60mg/d,another group was given Tamoxifen 20mg/d,and the third group wan given nothing as control.The hepatic function and serum lipid was measured prior to administration and 3,6,9,12 months after the start of administration.The hepatic function parameter contained alanine aminotransferase(ALT),aspartate aminoranferase(AST),alkaline phophatase(ALP)andγ-glutamyltransfarase(ALP). The serum lipid parameter contained triglyceride(TG),total cholesterol(CHOL), high-density lipoprotein(HDL),low-density lipoprotein(SDL)and very low-density lipoprotein(VSDL).ResultFellow up for 12 months,both antiestrogens have no effects on hepatic function.ALP was significantly increased by 30.47%(P=0.005)in the control team.And there are differences among the three teams.LDL was significantly decreased by 19.81% (P=0.001)in the TAM group,there is no difference between the three team.HDL was significantly increased by 28.57%(P＜0.001)in the TOR group.And there are differences between the three teams.ConclusionBoth TAM and TOR has no side effect on hepatic function after administration for 12 months,on the contract,in the control group,ALP was significantly increased,and there are differences between the three teams.In the TAM group LDL decreased significantly,there is no difference between the three teams.In the TOR group HDL increased significantly,indicated that TAM and TOR had regulative effect on the serum lipids.