Kenemans and colleagues have recently reported the effects of tibolone, as compared to placebo, on risk of recurrence in breast cancer patients with climacteric complaints . During 2002–2004, in the prospective multicenter LIBERATE trial, as many as 3148 women, after surgery for confirmed breast cancer and with vasomotor symptoms, were randomized to receive either tibolone 2.5 mg daily or placebo. Their mean age was 52.7 ± 7.3 years, the mean time since surgery was 2.1 ± 1.3 years, 58% were node-positive, 78% were estrogen receptor-positive, 67% used tamoxifen and 6.5% used aromatase inhibitors. The mean daily number of hot flushes was 6.4 ± 5.1.
After a median follow-up of 3.1 years (range 0.01–4.99 years), 237 of 1556 (15.2%) women on tibolone had a recurrence, compared with 165 of 1542 (10.7%) on placebo (hazard ratio (HR) 1.40; 95% confidence interval (CI) 1.14–1.70; p = 0.001). Tibolone was not different from placebo with regard to other safety outcomes, such as mortality, cardiovascular events or gynecological cancers. Vasomotor symptoms and bone mineral density improved significantly with tibolone compared with placebo.
Bo von Schoultz
Department of Obstetrics and Gynecology, Karolinska Institutet and University Hospital, Stockholm, Sweden
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