open access

Vol 8, No 6 (2012)
Review paper
Published online: 2013-01-24
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The place of exemestane in the treatment of advanced breast cancer in postmenopausal patients

Aleksandra Łacko, Renata Duchnowska
Onkol. Prak. Klin 2012;8(6):246-251.

open access

Vol 8, No 6 (2012)
REVIEW ARTICLES
Published online: 2013-01-24

Abstract

„Third generation” aromatase inhibitors (AIs) are compounds with proven efficacy in the treatment of
early and advanced hormone sensitive breast cancer in postmenopausal women. Due to the distinct
mechanism of interaction with aromatase, AIs are divided into steroidal (exemestane) and nonsteroidal
(anastrozole, letrozole) inhibitors. AIs inhibit activity of aromatase — an enzyme involved in the conversion
of androgens (testosterone, androstenedione) into estrogens (estrone, 17-beta estradiol). In several phase
III studies all „third generation” AIs shown to be superior to tamoxifen and progestins in advanced breast
cancer. Due to partial non-cross resistance, sequential use of steroidal and nonsteroidal AIs may provide
considerable clinical benefit. Since non-steroidal AIs are typically used in first-line treatment, exemestane
constitutes a valuable second or third line treatment option. Recently, a combination of exemestane with
everolimus, an m-TOR (mammalian target of rapamycine) inhibitor, has been shown to provide clinical
benefit in patients progressing on nonsteroidal AIs.

Abstract

„Third generation” aromatase inhibitors (AIs) are compounds with proven efficacy in the treatment of
early and advanced hormone sensitive breast cancer in postmenopausal women. Due to the distinct
mechanism of interaction with aromatase, AIs are divided into steroidal (exemestane) and nonsteroidal
(anastrozole, letrozole) inhibitors. AIs inhibit activity of aromatase — an enzyme involved in the conversion
of androgens (testosterone, androstenedione) into estrogens (estrone, 17-beta estradiol). In several phase
III studies all „third generation” AIs shown to be superior to tamoxifen and progestins in advanced breast
cancer. Due to partial non-cross resistance, sequential use of steroidal and nonsteroidal AIs may provide
considerable clinical benefit. Since non-steroidal AIs are typically used in first-line treatment, exemestane
constitutes a valuable second or third line treatment option. Recently, a combination of exemestane with
everolimus, an m-TOR (mammalian target of rapamycine) inhibitor, has been shown to provide clinical
benefit in patients progressing on nonsteroidal AIs.
Get Citation

Keywords

advanced breast cancer; endocrine therapy; aromatase inhibitors; exemestane

About this article
Title

The place of exemestane in the treatment of advanced breast cancer in postmenopausal patients

Journal

Oncology in Clinical Practice

Issue

Vol 8, No 6 (2012)

Article type

Review paper

Pages

246-251

Published online

2013-01-24

Bibliographic record

Onkol. Prak. Klin 2012;8(6):246-251.

Keywords

advanced breast cancer
endocrine therapy
aromatase inhibitors
exemestane

Authors

Aleksandra Łacko
Renata Duchnowska

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