Neo-adjuvant exemestane in elderly patients with breast cancer: a phase II, multicentre, open-label, Italian study.

Abstract

BACKGROUND:

The steroidal aromatase inhibitor exemestane has demonstrated efficacy for the treatment of breast cancer in the metastatic and adjuvant settings. Smaller trials have also reported efficacy in the neo-adjuvant setting.

PATIENTS AND METHODS:

This phase II, open-label, multicentre study examined the efficacy and safety of neo-adjuvant exemestane in women aged >70 years with operable, receptor-rich breast cancer. Consecutive eligible patients received exemestane 25 mg/day for 6 months before planned surgery. The primary end point was clinical response.

RESULTS:

Overall, 117 patients were recruited (median age 80 years). The objective response rate in 112 assessable patients (85 with clinical and mammographic evaluation; 27 with clinical evaluation only) was 69.6% (two complete responses; 76 partial responses). In patients who responded, median tumour size reduced from 4.81 to 2.12 cm. Seventy-seven patients (68.7%) continued to surgery. Of the 40 patients eligible for breast-conserving surgery, 34 (85%) deemed unfit for this procedure at baseline. Exemestane-related adverse events were unremarkable except for grade 3 allergic skin reactions in two patients (1.8%).

CONCLUSION:

Neo-adjuvant exemestane given for 6 months appears to be effective for receptor-rich breast cancer in older patients. There may now be sufficient evidence to support the use of neo-adjuvant in this patient population.

• Authors: G Mustacchi, M Mansutti, C Sacco, S Barni, A Farris, M Cazzaniga, M Cozzi, C Dellach
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 20 Issue 4 Pg. 655-9 (Apr 2009) ISSN: 1569-8041 [Electronic] England
• PMID: 19150936 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)

Chemical References

• Androstadienes
• Antineoplastic Agents
• exemestane

Topics

• Aged
• Aged, 80 and over
• Androstadienes (administration & dosage, adverse effects, therapeutic use)
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Breast Neoplasms (drug therapy, surgery)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Female
• Humans
• Treatment Outcome