Study Reviews

Omega-3 could improve adherence to treatment in patients treated with aromatase inhibitors

  • 08/17/2018

Aromatase activity in the breast increases in many cases of breast cancer. Aromatase inhibitors interfere in the production of oestrogens from androgens, reducing the activity of the aromatase enzyme. With regard to women treated with tamoxifen, those who take aromatase inhibitors report more oestrogen deficiency-related symptoms and also more adverse musculoskeletal effects, including arthralgia and myalgia. This means that although aromatase inhibitors lengthen survival among post-menopausal women with breast cancer, the accompanying arthralgia can lead to the abandonment of treatment.

The yearly meeting of the American Society of Clinical Oncology saw the presentation of the results from a randomised placebo-controlled trial on the effects of omega-3 fatty acid (FA) supplementation in obese patients on treatment with aromatase inhibitors (who have higher rates of arthralgia than non-obese subjects). The trial included 249 post-menopausal women with stage I-III breast cancer, treated with aromatase inhibitors (56% with a body mass index (BMI) >30 and 44% with BMI ≥30), who were randomly assigned to receive omega-3 FA or placebo for 24 weeks. A serum test was performed at the start and after 6, 12 and 24 weeks and the patients completed the Brief Pain Inventory. In participants with BMI ≥30, omega-3 FA consumption was associated with a significant reduction in triglycerides after 12 weeks and a significant improvement in the pain inventory score after 24 weeks compared to placebo.

In conclusion, in patients with BMI ≥30, consumption of omega-3 FA was significantly associated with a reduction in aromatase inhibitor-induced arthralgia and triglyceride levels compared to the placebo group. These results suggest that supplementation with omega-3 FA could improve adherence to treatment in this subgroup of patients.

Shen S, Unger JM, Crew KD, Till C, Greenlee H, Gralow J, et al. Abstract 10000. Presented at: ASCO Annual Meeting; June 3, 2018; Chicago.

Fabian CJ. The what, why and how of aromatase inhibitors: hormonal agents for treatment and prevention of breast cancer. Int J Clin Pract. 2007;61(12):2051-63.