Clinical utility of exemestane in the treatment of breast cancer

Giorgia Zucchini, Elena Geuna, Andrea Milani, Caterina Aversa, Rossella Martinello, Filippo Montemurro

Research output: Contribution to journalArticle

Abstract

Breast cancer is the most prevalent cancer in women, causing a significant mortality worldwide. Different endocrine strategies are available for the treatment of hormone-sensitive breast cancer, including antiestrogen tamoxifen and fulvestrant, as well as third-generation aromatase inhibitors (AIs), such as letrozole, anastrozole, and exemestane. In this review, we will focus on exemestane, its clinical use, and its side effects. Exemestane is a steroidal third-generation AI now used in all treatment settings for breast cancer. In the metastatic disease, it has been extensively investigated as the first-, second-, and further-line treatment and it is now registered for the treatment of postmenopausal women with advanced estrogen-receptor-positive breast cancer whose disease has progressed following antiestrogen therapy. A potential lack of cross-resistance with nonsteroidal AIs has been described, giving additional therapeutic opportunities in sequences of endocrine agents. Exemestane is also approved for the adjuvant treatment of postmenopausal early breast cancer, either as upfront monotherapy for 5 years, as a switch following 2–3 years of tamoxifen, or as extended therapy beyond 5 years of adjuvant treatment. New promising data also showed a beneficial effect in young premenopausal early breast cancer patients, when administered together with ovarian suppression. Interesting results have also emerged when exemestane has been investigated as neodjuvant treatment as well as preventive agent in healthy women at high risk for breast cancer. Exemestane is generally well tolerated, with a side effect profile similar to that of other AIs, including menopausal symptoms, arthralgia, and bone loss. In conclusion, exemestane can be considered an effective and well-tolerated endocrine treatment option for all stages of breast cancer.

Original languageEnglish
Pages (from-to)551-563
Number of pages13
JournalInternational Journal of Women's Health
Volume7
DOIs
Publication statusPublished - May 27 2015

Fingerprint

exemestane
Breast Neoplasms
Aromatase Inhibitors
Therapeutics
Estrogen Receptor Modulators
letrozole
Tamoxifen

Keywords

  • Aromatase inhibitors
  • Breast cancer
  • Endocrine therapy
  • Exemestane

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Maternity and Midwifery

Cite this

Clinical utility of exemestane in the treatment of breast cancer. / Zucchini, Giorgia; Geuna, Elena; Milani, Andrea; Aversa, Caterina; Martinello, Rossella; Montemurro, Filippo.

In: International Journal of Women's Health, Vol. 7, 27.05.2015, p. 551-563.

Research output: Contribution to journalArticle

Zucchini, Giorgia ; Geuna, Elena ; Milani, Andrea ; Aversa, Caterina ; Martinello, Rossella ; Montemurro, Filippo. / Clinical utility of exemestane in the treatment of breast cancer. In: International Journal of Women's Health. 2015 ; Vol. 7. pp. 551-563.
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