Clinical evaluation of the use of exemestane as further hormonal therapy after nonsteroidal aromatase inhibitors in postmenopausal metastatic breast cancer patients.
OBJECTIVE
The aromatase inhibitors Anastrozole, Letrozole (type 2 nonsteroidal aromatase inhibitors: n-SAI) and Exemestane (type 1 steroidal aromatase inactivator) are used respectively as first- and second-line hormonal therapy in postmenopausal metastatic breast cancer women. Few clinical data are published on the sequential use of different classes of aromatase inhibitors.


METHODS
We report an analysis on 30 postmenopausal metastatic breast cancer women treated between January 2000 and May 2002 in 2 Italian Oncology Institutions with the hormonal sequence n-SAI (Anastrozole, Letrozole) --> Exemestane.


RESULTS
When receiving n-SAI (Anastrozole 8 patients and Letrozole 22 patients), 1 out of 30 women achieved a partial response, 20 of 30 patients no change (NC) > or =6 months. The analysis of the entire population treated with Exemestane showed an overall clinical benefit (CB) of 46.6 percent (14/30) with a median duration of 12 months (95%CI 6-25) and a median time to progression (TTP) of 4 months (95%CI 1-25).


CONCLUSIONS
These data confirm a partial lack of cross-resistance between n-SAI --> Exemestane given in sequence.
Carlini
Paolo
P
Department of Medical Oncology, Regina Elena Cancer Institute, Rome, Italy. pcarlini@iol.it
Michelotti
Andrea
A
Ferretti
Gianluigi
G
Ricci
Sergio
S
Giannarelli
Diana
D
Pellegrini
Manuela
M
Cresti
Nicola
N
Di Cosimo
Serena
S
Bria
Emilio
E
Papaldo
Paola
P
Fabi
Alessandra
A
Ruggeri
Enzo Maria
EM
Milella
Michele
M
Alimonti
Andrea
A
Salesi
Nello
N
Cognetti
Francesco
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D000730:Androstadienes / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077289:Letrozole; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use; D017698:Postmenopause; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use
D000730:Androstadienes; D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D000077289:Letrozole; C056516:exemestane