Exemestane in postmenopausal women with early or advanced breast cancer: a review.
BACKGROUND
Inhibition of the aromatase enzyme in postmenopausal women reduces levels of estrogens, which is of therapeutic value in hormone-sensitive breast cancer. Exemestane is a third-generation steroidal irreversible inactivator of the aromatase enzyme used in early and advanced breast cancer for the treatment of postmenopausal women with estrogen-receptor-positive disease.


METHODS
The scientific literature on exemestane, including published articles and abstracts, was searched from 1988 to the present, and the most significant results are included in the review.


RESULTS
The review outlines the pharmacological characteristics of exemestane and the evidence supporting its use in the treatment of postmenopausal women with early or advanced estrogen-receptor-positive breast cancer.


CONCLUSIONS
Exemestane is an effective and well-tolerated aromatase inhibitor with a defined role in early-stage breast cancer following 2 - 3 years of adjuvant treatment with tamoxifen. Exemestane also has a role in the sequence of hormonal agents employed to control advanced hormone-sensitive breast cancer, in which clinicians may exploit its partial lack of cross-resistance with nonsteroidal aromatase inhibitors.
Bertelli
Gianfilippo
G
Singleton Hospital, South West Wales Cancer Institute, Sketty Lane, Swansea SA28QA, Wales, UK. gian.bertelli@wales.nhs.uk
Gangadhara
Sharath
S
D000730:Androstadienes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D017698:Postmenopause
D000730:Androstadienes; D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; C056516:exemestane