Exemestane
Produces Responses After Prior Aromatase Agents
According to results presented at the 2003 San Antonio Breast
Cancer Symposium, the aromatase agent exemestane (Aromasin ®)
produces anti-cancer responses in postmenopausal women with
metastatic breast cancer that has stopped responding to other
aromatase inhibitors.
Breast cancer is diagnosed in over 200,000 women annually
in the United States alone. Although cure rates are high if
breast cancer is diagnosed and treated prior to the spread
of cancer, long-term survival remains dismal among most patients
with cancer that has spread to distant sites in the body,
referred to metastatic breast cancer. One common type of breast
cancer is referred to as hormone-positive breast cancer. This
type of breast cancer is stimulated to grow by the common
female hormones estrogen and/or progesterone. Patients with
hormone-positive breast cancer are treated with therapy referred
to as hormone therapy that typically consists of agents that
either block the production of estrogen in a body, or block
the growth-stimulatory effects of estrogen on a cell. Historically,
the agent tamoxifen (Nolvadex ®), which blocks estrogen
from being able to bind to a cell, was the standard drug used
as hormone therapy in breast cancer. More recently, a newer
class of agents, referred to as aromatase agents, have entered
the clinical setting for treatment of postmenopausal women
with hormone-positive breast cancer. Several clinical trials
are ongoing to determine the optimal sequencing and duration
of treatment of the different hormone agents.
Researchers from England recently reviewed data evaluating
the aromatase agent exemestane in the treatment of postmenopausal,
hormone-positive breast cancer that had stopped responding
to prior aromatase agents. The data included 96 patients who
had been treated with either 1, 2, or 3 prior hormone agents,
including at least one aromatase agent. Exemestane produced
clinical benefit (anti-cancer responses or disease stabilization)
in nearly 40% of patients. The average time to cancer progression
while on exemestane was approximately 4 months, and the average
survival time from initiation of exemestane was 55 weeks for
the entire group of patients. However, patients who achieved
a clinical benefit from exemestane had not yet reached the
average duration of survival at the time of publication of
this trial. Furthermore, the number of prior hormone therapies
did not significantly affect time to cancer progression and
overall survival in these patients.
The researchers concluded that exemestane appears to provide
clinical benefit in postmenopausal women with metastatic,
hormone-positive breast cancer that has stopped responding
to previous hormone therapy, including prior aromatase agents.
Postmenopausal women with hormone-positive breast cancer that
has stopped responding to hormone therapy may wish to speak
with their physician about the risks and benefits of exemestane
or the participation in a clinical trial evaluating other
hormonal agents or therapeutic approaches. Two sources of
information regarding ongoing clinical trials include the
National Cancer Institute ( cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches are also performed on
behalf of patients at cancerconsultants.com.
Reference: Fernie N, Zekri J, Leonard R, et al. Exemestane
in metastatic breast cancer: effective therapy after 3rd generation
aromatase inhibitor failure. Proceedings from the 26th annual
San Antonio Breast Cancer Symposium. December 2003. Abstract
#435.
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