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. 1990 Nov;31(6):381–386. doi: 10.1007/BF01741410

The immunological status of breast cancer patients during treatment with a new antiestrogen, toremifene

Ritva Valavaara 1,✉, Juhani Tuominen 2, Auli Toivanen 3,4
PMCID: PMC11038112  PMID: 2143689

Abstract

The immune status of breast cancer patients was followed during antiestrogen treatment for at least 1 year or until progression of the disease. Twelve postmenopausal women with advanced estrogen-receptor-positive breast cancer were treated with a novel antiestrogen, toremifene. Immune functions were determined before the start of the treatment and at 3, 6, and 12 months. For NK cell cytotoxicity testing there were 74 healthy controls and for T cell subset measurements 28 healthy controls. No statistically significant changes in the T cell subsets or NK cell cytotoxicity were observed during treatment. However, throughout toremifene treatment patients had fewer CD4 cells (T helper lymphocytes) than did the controls. Cancer patients had higher pretreatment B cell values than the controls,P = 0.01, but during the first months of toremifene treatment B cell values decreased and remained within the normal range thereafter. A positive effect on mitogen-stimulation tests with phytohemagglutinin (PHA) and concanavalin A (ConA) was observed during the first months of treatment (P = 0.01 for PHA and 0.03 for log [ConA] and a stabilization at the higher level thereafter. These results indicate that toremifene has a stimulatory effect on cell-mediated immunity in breast cancer patients.

Keywords: Breast Cancer, Breast Cancer Patient, Postmenopausal Woman, Immune Function, Cell Subset

References

  • 1.Adler A, Stein JA, Ben-Efraim S. Immunocompetence, immunosuppression, and human breast cancer. III. Prognostic significance of initial level of immunocompetence in early and advanced disease. Cancer. 1980;45:2074–2074. doi: 10.1002/1097-0142(19800415)45:8<2074::aid-cncr2820450814>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  • 2.Berry J, Green BJ, Matheson DS. Modulation of natural killer cell activity by tamoxifen in stage I postmenopausal breast cancer. Eur J Cancer Clin Oncol. 1987;23:517–517. doi: 10.1016/0277-5379(87)90313-0. [DOI] [PubMed] [Google Scholar]
  • 3.Cohen JHM, Danel L, Cordier G, Saez S, Revillard JP. Sex steroid receptors in peripheral T cells: absence of androgen receptors and restriction of estrogen receptors to OKT8 positive cells. J Immunol. 1983;131:2767–2767. [PubMed] [Google Scholar]
  • 4.Dillman RO, Koziol JA, Zavanelli MI, et al. Immunoincompetence in cancer patients. Cancer. 1984;53:1484–1484. doi: 10.1002/1097-0142(19840401)53:7<1484::aid-cncr2820530710>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  • 5.Eskola J, Soppi E, Viljanen M, et al. A new micromethod for lymphocyte stimulation using whole blood. Immunol Commun. 1975;4:297–297. doi: 10.3109/08820137509055781. [DOI] [PubMed] [Google Scholar]
  • 6.Giorgi JV. Lymphocyte subset measurements: significance in clinical medicine. In: Rose NR, Friedman H, Fahey JL, editors. Manual of Clinical an Laboratory Immunology. 3rd ed. Washington, DC: Am Soc Microbiol; 1986. pp. 236–236. [Google Scholar]
  • 7.Grossman CJ. Regulation of the immune system by sex steroids. Endocrinol Rev. 1984;5:435–435. doi: 10.1210/edrv-5-3-435. [DOI] [PubMed] [Google Scholar]
  • 8.Joensuu H, Toivanen A, Nordman E. Effect of tamoxifen on immune functions. Cancer Treat Rep. 1986;70:381–381. [PubMed] [Google Scholar]
  • 9.Kallio S, Kangas L, Blanco G, et al. A new triphenylethylene compound, FC-1157 A. I. Hormonal effects. Cancer Chemother Pharmacol. 1986;17:103–103. doi: 10.1007/BF00306736. [DOI] [PubMed] [Google Scholar]
  • 10.Kangas L, Nieminen A-L, Blanco G, et al. A new triphenylethylene compound, FC-1157 A. II. Antitumour effects. Cancer Chemother Pharmacol. 1986;17:109–109. doi: 10.1007/BF00306737. [DOI] [PubMed] [Google Scholar]
  • 11.Mandeville R, Lamoureux G, Legault-Poisson S, Poisson R. Biological markers and breast cancer. A multiparametric study. II. Depressed immune competence. Cancer. 1982;50:1280–1280. doi: 10.1002/1097-0142(19821001)50:7<1280::aid-cncr2820500710>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  • 12.Mandeville R, Ghali SS, Chausseau JP. In vitro stimulation of human NK activity by an estrogen antagonist (Tamoxifen) Eur J Cancer Clin Oncol. 1984;20:983–983. doi: 10.1016/0277-5379(84)90174-3. [DOI] [PubMed] [Google Scholar]
  • 13.Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207–207. doi: 10.1002/1097-0142(19810101)47:1<207::aid-cncr2820470134>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  • 14.Paavonen T, Anderson LC. The oestrogen antagonists, tamoxifen and FC-1157 a, display oestrogen like effects on human lymphocyte functions in vitro. Clin Exp Immunol. 1985;61:467–467. [PMC free article] [PubMed] [Google Scholar]
  • 15.Paavonen T, Andersson LC, Adlercreuz H. Sex hormone regulation of in vitro immune response. J Exp Med. 1981;154:1935–1935. doi: 10.1084/jem.154.6.1935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Paterson AG, Webster DJT. The predictive value of T-lymphocyte counts in advanced breast-cancer patients treated with tamoxifen. Br J Cancer. 1982;45:637–637. [Google Scholar]
  • 17.Rotstein S, Blomgren H, Petrini B, Wasserman J, Nilsson B, Baral E. Blood lymphocyte counts with subset analysis in operable breast cancer. Relation to the extent of tumor disease and prognosis. Cancer. 1985;56:1413–1413. doi: 10.1002/1097-0142(19850915)56:6<1413::aid-cncr2820560632>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  • 18.Rotstein S, Blomgren H, Petrini B, Wasserman J, Baral E. Long term effects on the immune system following local radiation therapy for breast cancer. I. Cellular composition of the peripheral blood lymphocyte population. Int J Radiat Oncology Biol Phys. 1985;11:921–921. doi: 10.1016/0360-3016(85)90114-2. [DOI] [PubMed] [Google Scholar]
  • 19.Rotstein S, Blomgren H, Petrini B, Wasserman J, Baral E. Long-term effects on the immune system following local radiation therapy for breast cancer: 4. Proliferative responses and induction of suppressor activity of the blood lymphocyte population. Radiother Oncol. 1986;6:223–223. doi: 10.1016/s0167-8140(86)80156-6. [DOI] [PubMed] [Google Scholar]
  • 20.Salo M. Surgery and the immune response. In: Paubert-Braquet M, editor. Lipid mediators in the immunology of shock. New York: Plenum; 1987. pp. 289–289. [Google Scholar]
  • 21.Scambia G, Panici PB, Maccio A, et al. Effects of antiestrogen and progestin on immune functions in breast cancer patients. Cancer. 1988;61:2214–2214. doi: 10.1002/1097-0142(19880601)61:11<2214::aid-cncr2820611115>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  • 22.Sheard CR, Reilly F, Tee DEH, et al. The effect of adjuvant cyclophosphamide or tamoxifen on the numbers of lymphocytes bearing T cell or NK cell markers. Br J Cancer. 1986;54:705–705. doi: 10.1038/bjc.1986.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Toivanen A, Nordman E. Long-term effect of postoperative irradiation on the immune fuctions in patients with mammary carcinoma. Acta Radiol Oncol. 1981;20:119–119. doi: 10.3109/02841868109130431. [DOI] [PubMed] [Google Scholar]
  • 24.Valavaara R, Pyrhönen S, Heikkinen M, et al. Toremifene, a new antiestrogenic compound for treatment of advanced breast cancer. Phase II study. Eur J Cancer Clin Oncol. 1988;24:785–785. doi: 10.1016/0277-5379(88)90316-1. [DOI] [PubMed] [Google Scholar]
  • 25.Webster DJT, Richardson G, Baum M, Priestman T, Hughes LE. Effect of treatment on the immunological status of women with advanced breast cancer. Br J Cancer. 1979;39:676–676. doi: 10.1038/bjc.1979.119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.West WH, Cannon GB, Kay HD, Bonnard GD, Herberman RB. Natural cytotoxic reactivity of human lymphocytes against a myeloid cell line: characterization of effector cells. J Immunol. 1977;118:355–355. [PubMed] [Google Scholar]
  • 27.Wärri A, Kangas L (1990) Effect of toremifene on the activity of NK-cells in NZB/NZW mice. J Steroid Biochem (in press) [DOI] [PubMed]
  • 28.Zaccheo T, Ornati G, di Salle E. Antiestrogenic and antitumor properties of the new triphenylethylene derivative toremifene in the rat. Budapest: 14th International Cancer Congress; 1986. [DOI] [PubMed] [Google Scholar]

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