title: Clinical evaluation of the use of exemestane as further hormonal therapy after nonsteroidal aromatase inhibitors in postmenopausal metastatic breast cancer patients.
abstract: 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.
authors: Department of Medical Oncology, Regina Elena Cancer Institute, Rome, Italy. pcarlini@iol.it
authors: Paolo
authors: P
authors: Carlini
authors: Andrea
authors: A
authors: Michelotti
authors: Gianluigi
authors: G
authors: Ferretti
authors: Sergio
authors: S
authors: Ricci
authors: Diana
authors: D
authors: Giannarelli
authors: Manuela
authors: M
authors: Pellegrini
authors: Nicola
authors: N
authors: Cresti
authors: Serena
authors: S
authors: Di Cosimo
authors: Emilio
authors: E
authors: Bria
authors: Paola
authors: P
authors: Papaldo
authors: Alessandra
authors: A
authors: Fabi
authors: Enzo Maria
authors: EM
authors: Ruggeri
authors: Michele
authors: M
authors: Milella
authors: Andrea
authors: A
authors: Alimonti
authors: Nello
authors: N
authors: Salesi
authors: Francesco
authors: F
authors: Cognetti
mesh_terms: 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
chemical_list: D000730:Androstadienes; D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D000077289:Letrozole; C056516:exemestane