Effects of selective estrogen receptor modulators on lipid metabolism in patients with breast cancer: A systematic review and meta-analysis
In brief
Selective estrogen modulators lower cholesterol but raise fatty liver risk 57%
In a meta-analysis of 19 studies, selective estrogen receptor modulators lowered total and LDL cholesterol compared with other breast cancer treatments, but triglycerides were higher and fatty liver risk was 57% higher. The findings point to a lipid trade-off, but the mix of trials and cohort studies leaves open how these changes affect patients' long-term health.
- Journal
- Journal of cancer research and therapeutics (Q2)
- Published
- 29 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Qianqian Wang, Ye Jiang, Yongli Li, Chengyuan Zhao, Jiahui Lao, Yang Yang, et al.
- PMID
- 42813852
- DOI
- 10.4103/jcrt.jcrt_248_26
Why clinicians should know about it
- Picked for Biochemistry (medical) (top studies of the week, 4 October 2026).
Abstract
BACKGROUND: Selective estrogen receptor modulators (SERMs) have certain effects on lipid metabolism; however, the results of various studies remain controversial. We conducted a meta-analysis to summarize the existing evidence from cohort studies and randomized controlled trials (RCTs) on the effect of SERM treatment on lipid metabolism in breast cancer patients. METHODS: We conducted a comprehensive search of PubMed, Embase, Cochrane, EBSCO, and the Web of Science databases through January 31, 2026, to identify articles focused on the effects of SERMs on lipid metabolism. Each study included the effect size and 95% confidence interval (95% CI) of the relationship between SERMs and lipid metabolism. Subgroup analyses were also performed to explore potential. RESULTS: A total of 19 studies (13 RCTs and 6 cohort studies) were included in the meta-analysis. SERMs showed significant differences from other breast cancer treatment methods in terms of total cholesterol (TC) (SMD = -0.70; 95% CI: -0.91, -0.50), triglycerides (TG) (SMD = 0.32; 95% CI: 0.06, 0.59), low-density lipoprotein (LDL-C) (SMD = -0.76; 95% CI: -1.02, -0.50), and the risk of fatty liver occurrence (RR = 1.57; 95% CI: 1.13, 2.18). CONCLUSIONS: SERMs exhibited significant efficacy in lowering LDL-C and TC; however, they may increase the risk of developing fatty liver. Clinical decision-making should involve a comprehensive evaluation of individual patient characteristics to optimize personalized treatment strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.