The Influence of Exemestane on the Lipid Profile in Breast Cancer Patients: A Meta-Analysis and Systematic Review of Randomized Controlled Trials

Abstract Controversial results exist regarding the influence of exemestane on serum lipids in women affected with breast cancer. Since CVD remains the predominate cause of demise in women with breast cancer and considering the long-term use of exemestane in women with breast cancer, this meta-analysis holds significant value. Hence, we carried out the current meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of exemestane treatment on lipid parameters in women with breast cancer. PubMed/Medline, Web of Science, EMBASE, and Scopus databases were explored for articles published from inception till December 3, 2024. A random effect analysis was employed for result generation as weighted mean differences (WMD) with 95% confidence intervals (CI). Six eligible and relevant RCTs were incorporated in this meta-analysis. The comprehensive findings from random effect analysis indicated a reduction in TC (WMD: –8.13 mg/dl, 95% CI: –14.48 to –1.79, p=0.012), HDL-C (WMD: –6.60 mg/dl; 95% CI: –8.17 to –5.01, p<0.001) and an increase in LDL-C (WMD: 4.66 mg/dl; 95% CI: 0.26 to 9.06, p=0.038) after exemestane intervention. Additionally, a noteworthy decline in the levels of TG was noted in studies lasting less than 12 months duration (WMD: –16.18 mg/dl; 95% CI: –25.99 to –6.37, p=0.001). Exemestane influences the lipid parameters in women with breast cancer. It elevates LDL-C levels while decreasing TC, TG, and HDL-C concentrations.