Table 3. Common or Serious Adverse Events Comparison Adverse Effect Hypercholesterolemia†
Tamoxifen % 19.2
Cardiac – any grade (serious)†
Hypertension – any grade† VTE – any grade (serious)† Lowered bone marrow density Bone fracture† Osteoporosis
Musculoskeletal/Arthralgia Gynecologic adverse effects Hot flashes†
Endometrial cancer† †
5.2 (1.4) 3.4
3.9 (2.3) –
5.4 – –
Higher rate 38
0.3
Aromatase Inhibitor % 43.6
5.7 (2.4) 3.8
1.7 (0.9)
Higher rate 8
Higher rate Higher rate –
33.5 0.1
NOTE: Based on BIG 1-98 clinical trial results as cited in ASCO's guideline. Other adverse effects from other trials cited in ASCO guideline.
Toxicities and Risks
ÎClinicians should consider the side effect profiles, patient preferences, and pre-existing conditions when recommending an adjuvant endocrine strategy for postmenopausal women.
ÎClinicians should discuss side effect profiles when presenting available treatment options to patients.
ÎClinicians should consider recommending that patients change treatment if side effects are intolerable or patients are persistently non-compliant with therapy.
ÎAdjuvant endocrine therapy agents are generally well tolerated, but are associated with specific toxicities.
ÎEach drug class has a distinct adverse effect profile that is relevant to individualizing therapy for patients.
ÎFour main categories of symptoms:
> Cardiovascular > Musculoskeletal > Gynecologic > Climacteric
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