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2
Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer.他莫昔芬在非转移性乳腺癌老年患者中的药代动力学和药效学。
Breast Cancer Res Treat. 2023 Jun;199(3):471-478. doi: 10.1007/s10549-023-06925-z. Epub 2023 Apr 17.
3
Effects of tamoxifen and exemestane on cognitive function in postmenopausal patients with breast cancer.他莫昔芬和依西美坦对绝经后乳腺癌患者认知功能的影响。
JNCI Cancer Spectr. 2023 Mar 1;7(2). doi: 10.1093/jncics/pkad022.
4
Association between endocrine therapy and cognitive decline in older women with early breast cancer: Findings from the prospective CLIMB study.早期乳腺癌老年女性内分泌治疗与认知功能下降的相关性：前瞻性 CLIMB 研究的结果。
Eur J Cancer. 2023 May;185:1-10. doi: 10.1016/j.ejca.2023.02.008. Epub 2023 Feb 17.
5
The impact of endoxifen-guided tamoxifen dose reductions on endocrine side-effects in patients with primary breast cancer.依西美坦治疗对原发性乳腺癌患者内分泌副作用的影响。
ESMO Open. 2023 Feb;8(1):100786. doi: 10.1016/j.esmoop.2023.100786. Epub 2023 Feb 6.
6
Toward model-informed precision dosing for tamoxifen: A population-pharmacokinetic model with a continuous CYP2D6 activity scale.迈向他莫昔芬的模型指导精准给药：一个具有连续CYP2D6活性量表的群体药代动力学模型。
Biomed Pharmacother. 2023 Apr;160:114369. doi: 10.1016/j.biopha.2023.114369. Epub 2023 Feb 6.
7
Multimodal MRI examination of structural and functional brain changes in older women with breast cancer in the first year of antiestrogen hormonal therapy.多模态 MRI 检查在抗雌激素激素治疗的第一年中老年乳腺癌女性的大脑结构和功能变化。
Breast Cancer Res Treat. 2022 Jul;194(1):113-126. doi: 10.1007/s10549-022-06597-1. Epub 2022 Apr 27.
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Prevalence of cognitive impairment following chemotherapy treatment for breast cancer: a systematic review and meta-analysis.化疗治疗乳腺癌后认知障碍的患病率：系统评价和荟萃分析。
Sci Rep. 2022 Feb 8;12(1):2135. doi: 10.1038/s41598-022-05682-1.
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Therapeutic Drug Monitoring of Endoxifen for Tamoxifen Precision Dosing: Feasible in Patients with Hormone-Sensitive Breast Cancer.他莫昔芬精准给药的依西美坦血药浓度监测：激素敏感型乳腺癌患者可行。
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Endocrine Therapy With or Without CDK4/6 Inhibitors in Women With Hormone-receptor Positive Breast Cancer: What do we Know About the Effects on Cognition?激素受体阳性乳腺癌女性使用或不使用CDK4/6抑制剂的内分泌治疗：我们对其认知影响了解多少？
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他莫昔芬对原发性乳腺癌患者认知功能的影响。

Effects of tamoxifen on cognitive function in patients with primary breast cancer.

作者信息

Luijendijk Maryse J, Buijs Sanne M, Jager Agnes, Koolen Stijn L W, van der Wall Elsken, Schagen Sanne B, Mathijssen Ron H J

机构信息

Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

出版信息

Br J Cancer. 2025 Feb;132(2):180-187. doi: 10.1038/s41416-024-02914-1. Epub 2024 Nov 26.

DOI:10.1038/s41416-024-02914-1
PMID:39592740
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11747089/
Abstract

INTRODUCTION

Tamoxifen may adversely affect cognitive function by interfering with estrogen action in the brain. Despite growing evidence for a relationship between tamoxifen and cognitive problems, findings remain inconclusive. While some tamoxifen-related side effects seem exposure-dependent with concentrations of tamoxifen or its main metabolite, endoxifen, this has never been investigated for cognitive function. We investigated cognitive function after two years of tamoxifen and its association with tamoxifen and endoxifen exposure.

METHODS

135 women with breast cancer completed the Amsterdam Cognition Scan (ACS), an online neuropsychological test battery, after two years of tamoxifen. Test scores were converted to standardized Z-scores based on a matched 'no-cancer' control group. Tamoxifen and endoxifen concentrations and tamoxifen dose were regressed separately on cognitive functioning.

RESULTS

Patients reported mild cognitive complaints and had worse verbal learning, processing speed, executive functioning, and motor functioning compared to matched controls. After correcting for age, mean tamoxifen and endoxifen levels, as well as tamoxifen dose, were associated with worse performance on several cognitive domains.

CONCLUSION

Tamoxifen is adversely associated with objective as well as self-reported cognitive function, which may depend on the level of exposure to tamoxifen and endoxifen. Further research is warranted to confirm this hypothesis.

摘要

引言

他莫昔芬可能通过干扰大脑中的雌激素作用对认知功能产生不利影响。尽管越来越多的证据表明他莫昔芬与认知问题之间存在关联，但研究结果仍无定论。虽然一些与他莫昔芬相关的副作用似乎与他莫昔芬或其主要代谢物内昔芬的浓度有关，但从未针对认知功能进行过此类研究。我们研究了服用他莫昔芬两年后的认知功能及其与他莫昔芬和内昔芬暴露的关联。

方法

135名乳腺癌女性在服用他莫昔芬两年后完成了阿姆斯特丹认知扫描（ACS），这是一项在线神经心理测试组合。根据匹配的“无癌症”对照组，将测试分数转换为标准化Z分数。分别对认知功能与他莫昔芬和内昔芬浓度以及他莫昔芬剂量进行回归分析。

结果

与匹配的对照组相比，患者报告有轻度认知主诉，在言语学习、处理速度、执行功能和运动功能方面表现更差。在校正年龄、他莫昔芬和内昔芬的平均水平以及他莫昔芬剂量后，发现这些因素与多个认知领域的较差表现相关。

结论

他莫昔芬与客观认知功能以及自我报告的认知功能均存在负相关，这可能取决于他莫昔芬和内昔芬的暴露水平。有必要进行进一步研究以证实这一假设。