Effects of exemestane: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Exemestane is a third-generation steroidal aromatase inhibitor used in the treatment of hormone-dependent breast cancer in postmenopausal women. Exemestane inhibits aromatase, an enzyme involved in estrogen synthesis, and reduces estrogen levels, thus inhibiting breast cancer cell growth. Numerous studies have shown that exemestane is an effective drug for treating breast cancer. 8 , 1

Many studies have shown that exemestane inhibits the growth of breast cancer cells. 9 , 4 , 13 , 5 In addition, exemestane has been shown to inhibit the activation of estrogen receptors, which promote the growth of breast cancer cells. 1

Exemestane may also decrease bone density. 8 , 16 , 12 , 7 , 14 However, the decrease in bone density caused by exemestane may be reversed after treatment cessation. 16

Exemestane may have estrogen-like effects on the postmenopausal uterus. 19 , 15 Exemestane may increase the thickness of the endometrium, potentially leading to endometrial abnormalities. 19

Exemestane may also affect cognitive function. 17 However, the effect of exemestane on cognitive function is not yet clear. 17

Benefits and Risks

Benefits Summary

Exemestane is an effective drug for the treatment of hormone-dependent breast cancer in postmenopausal women. Exemestane inhibits the growth of breast cancer cells and can slow the progression of breast cancer. In addition, exemestane may have less impact on bone density compared to other aromatase inhibitors. Numerous studies have shown that exemestane is an effective drug for treating hormone-dependent breast cancer in postmenopausal women. 4 , 9 , 13 , 5

Risks Summary

Exemestane may decrease bone density. 8 , 16 , 12 , 7 , 14 Exemestane may also have estrogen-like effects on the postmenopausal uterus, potentially leading to endometrial abnormalities. 19 , 15 Exemestane may also affect cognitive function. 17 It is important to take exemestane as directed by your doctor because of the risk of side effects.

Comparison of Studies

Commonalities of Studies

Many studies have shown that exemestane inhibits the growth of breast cancer cells. 9 , 4 , 13 , 5 In addition, studies have also demonstrated that exemestane may decrease bone density. 8 , 16 , 12 , 7 , 14

Differences Between Studies

Whether the decrease in bone density caused by exemestane is reversible after treatment cessation varies by study. 16 Likewise, whether exemestane has estrogen-like effects on the postmenopausal uterus varies by study. 19 , 15 The effect of exemestane on cognitive function is not yet clear. 17

Consistency and Contradictions in Findings

Exemestane has been consistently shown to inhibit the growth of breast cancer cells in numerous studies. 9 , 4 , 13 , 5 However, research findings vary on whether the decrease in bone density caused by exemestane is reversible after treatment cessation. 16 Additionally, the findings on whether exemestane has estrogen-like effects on the postmenopausal uterus are inconsistent across studies. 19 , 15 The effect of exemestane on cognitive function also requires further investigation. 17

Practical Applications and Cautions

Exemestane has been shown in numerous studies to be an effective drug for the treatment of hormone-dependent breast cancer in postmenopausal women. 4 , 9 , 13 , 5 However, because exemestane carries the risk of side effects, it is crucial to take it as prescribed by your doctor. Exemestane may decrease bone density. 8 , 16 , 12 , 7 , 14 Additionally, it may have estrogen-like effects on the postmenopausal uterus, potentially leading to endometrial abnormalities. 19 , 15 Exemestane may also affect cognitive function. 17 Consulting with your doctor regarding the risks associated with exemestane before taking it is essential.

Limitations of Current Research

Research on exemestane is still limited. More studies are needed to fully understand the effects of exemestane on bone density, the endometrium, and cognitive function. Additionally, further research is required to understand the effects of combining exemestane with other medications.

Future Research Directions

Future research on exemestane should focus on more in-depth studies of the drug's effects on bone density, the endometrium, and cognitive function. Additionally, more research is needed to understand the effects of combining exemestane with other medications. Developing biomarkers that can predict the effects of exemestane on an individual level is another area of future research.

Conclusion

Exemestane is an effective drug for the treatment of hormone-dependent breast cancer in postmenopausal women, as evidenced by numerous studies. 4 , 9 , 13 , 5 However, it is crucial to take exemestane as prescribed by your doctor because of the risk of side effects. Consulting with your doctor regarding the risks associated with exemestane before taking it is essential.

Literature analysis of 19 papers
Positive Content
18
Neutral Content
0
Negative Content
1
Article Type
10
0
0
1
19
3.

Effects of exemestane and letrozole therapy on plasma concentrations of estrogens in a randomized trial of postmenopausal women with breast cancer.

Author: RobargeJason D, DestaZereunesay, NguyenAnne T, LiLang, HertzDaniel, RaeJames M, HayesDaniel F, StornioloAnna M, StearnsVered, FlockhartDavid A, SkaarTodd C, HenryN Lynn

Breast cancer treatment

Aromatase inhibitors (AIs) are medications used to treat breast cancer by blocking the production of estrogen. This study investigated the levels of estrogen in the blood of breast cancer patients who were taking AIs. The study found that there was significant variability in estrogen levels among patients, suggesting that individual responses to AI therapy may vary.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Exemestane metabolites: Synthesis, stereochemical elucidation, biochemical activity and anti-proliferative effects in a hormone-dependent breast cancer cell line.

Author: VarelaCarla L, AmaralCristina, Tavares da SilvaElisiário, LopesAndreia, Correia-da-SilvaGeorgina, CarvalhoRui A, CostaSaul C P, RoleiraFernanda M F, TeixeiraNatércia

Aromatase inhibition
Breast cancer treatment

This study investigates the potential for exemestane metabolites to contribute to the drug's efficacy in treating breast cancer. Exemestane is a steroidal aromatase inhibitor that inhibits estrogen production. The study analyzes the activity of four exemestane metabolites, showing that they also possess aromatase inhibitory activity and can reduce breast cancer cell viability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

[Combination of exemestane and everolimus may produce toxic side effects: a new treatment option for metastatic hormone-sensitive breast cancer].

Author: VincentJeroen, de BoerMaaike, LobbezooDorien J A, SmeetsRuud E H, Tjan-HeijnenVivianne C G

Breast cancer treatment
Side effects

The combination of exemestane and everolimus is a new treatment option for metastatic hormone-sensitive breast cancer. This article discusses the efficacy and common side effects of this treatment, along with recommendations for their management.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Dutch

7.

Effects of adjuvant exemestane versus anastrozole on bone mineral density for women with early breast cancer (MA.27B): a companion analysis of a randomised controlled trial.

Author: GossPaul E, HershmanDawn L, CheungAngela M, IngleJames N, KhoslaSundeep, StearnsVered, ChalchalHaji, RowlandKendrith, MussHyman B, LindenHannah M, ScherJudite, PritchardKathleen I, ElliottCatherine R, Badovinac-CrnjevicTanja, St LouisJessica, ChapmanJudith-Anne W, ShepherdLois E

Breast cancer treatment
Bone damage

Exemestane, an aromatase inhibitor used for breast cancer treatment, may have a less detrimental effect on bone mineral density than anastrozole, another aromatase inhibitor. This suggests that exemestane, with its mild androgenic properties, may be a better option for bone health in breast cancer patients.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Effects of Exemestane and Tamoxifen treatment on bone texture analysis assessed by TBS in comparison with bone mineral density assessed by DXA in women with breast cancer.

Author: KalderMatthias, HansDidier, KyvernitakisIoannis, LamyOlivier, BauerMartina, HadjiPeyman

Improved bone texture
Increased bone density
Decreased bone density
Deteriorated bone texture

This analysis of a substudy from the Tamoxifen Exemestane Adjuvant Multinational trial evaluated the effects of exemestane and tamoxifen on bone mineral density and bone texture analysis in postmenopausal women with hormone receptor-positive breast cancer.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Synergistic effects of exemestane and aspirin on MCF-7 human breast cancer cells.

Author: HuLi-Xia, DuYing-Ying, ZhangYing, PanYue-Yin

Increased antiproliferative effect

The combination of exemestane and aspirin might become a useful method to the treatment of hormone- dependent breast cancer. The combination of the two inhibitors significantly increased the response as compared to single agent treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Effects of exemestane and tamoxifen on hormone levels within the Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial: results of a German substudy.

Author: HadjiP, KaukaA, BauerT, TamsJ, HasenburgA, KiebackD G

Exemestane and tamoxifen had different effects on hormone levels in postmenopausal patients with hormone receptor-positive breast cancer. Exemestane increased testosterone, DHEAS, and FSH levels, while tamoxifen decreased these hormones.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Effects of exemestane, anastrozole and tamoxifen on bone mineral density and bone turnover markers in postmenopausal early breast cancer patients: results of N-SAS BC 04, the TEAM Japan substudy.

Author: AiharaT, SuemasuK, TakeiH, HozumiY, TakeharaM, SaitoT, OhsumiS, MasudaN, OhashiY

Bone protection
Bone loss

Tamoxifen may provide better bone protection compared with exemestane or anastrozole. BMD at 2 years of treatment was higher in tamoxifen patients compared with exemestane and anastrozole patients. NTX and BAP were significantly lower in tamoxifen patients compared with exemestane and anastrozole patients at 1 and 2 years of treatment (p < 0.05).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Aromatase inhibitor exemestane has antiproliferative effects on human mesothelioma cells.

Author: StoppoloniDaniela, SalvatoriLuisa, BiroccioAnnamaria, D'AngeloCarmen, MutiPaola, VerdinaAlessandra, SacchiAda, VincenziBruno, BaldiAlfonso, GalatiRossella

Tumor growth inhibition

Aromatase (CYP19A1) was found in malignant mesothelioma (MM) cells, and its activity was increased by various stimuli. Exemestane, a CYP19A1 inhibitor, reduced tumor cell growth and activated apoptosis, suggesting potential for new treatment strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

A randomized, placebo-controlled trial (NCIC CTG MAP.2) examining the effects of exemestane on mammographic breast density, bone density, markers of bone metabolism and serum lipid levels in postmenopausal women.

Author: CiglerT, RichardsonH, YaffeM J, FabianC J, JohnstonD, IngleJ N, NassifE, BrunnerR L, WoodM E, PaterJ L, HuH, QiS, TuD, GossP E

Bone resorption marker
Lipid metabolism effects
BMD unchanged
Breast density unchanged

Exemestane, a drug used to treat breast cancer, did not significantly reduce mammographic breast density in postmenopausal women after one year of treatment. It did, however, result in a reversible increase in bone resorption, as measured by the marker N-telopeptide. Exemestane also led to a significant decrease in total and HDL cholesterol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Endometrial effects of exemestane compared to tamoxifen within the Tamoxifen Exemestane Adjuvant Multicenter (TEAM) trial: results of a prospective gynecological ultrasound substudy.

Author: KiebackD G, HarbeckN, BauerW, HadjiP, WeyerG, MenschikT, HasenburgA

Reduced endometrial thickening

Exemestane was associated with significantly less endometrial thickening than tamoxifen during adjuvant endocrine therapy for postmenopausal hormone receptor-positive breast cancer.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Reversal of skeletal effects of endocrine treatments in the Intergroup Exemestane Study.

Author: ColemanRobert E, BanksLinda M, GirgisSamia I, VrdoljakEduard, FoxJohn, CawthornSimon J, PatelAshraf, BlissJudith M, CoombesR Charles, KilburnLucy S

Bone health recovery
Bone density decline

This study examines the effects of endocrine treatment withdrawal on bone health in patients with breast cancer who were previously treated with tamoxifen or exemestane. The results show that the bone effects of exemestane are reversed after treatment withdrawal.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial.

Author: SchilderChristina M, SeynaeveCaroline, BeexLouk V, BoogerdWillem, LinnSabine C, GundyChad M, HuizengaHilde M, NortierJohan W, van de VeldeCornelis J, van DamFrits S, SchagenSanne B

Exemestane cognitive benefit
Tamoxifen cognitive impairment

After 1 year of adjuvant therapy, tamoxifen use is associated with statistically significant lower functioning in verbal memory and executive functioning, whereas exemestane use is not associated with statistically significant lower cognitive functioning in postmenopausal patients with BC.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

A randomized trial exploring the biomarker effects of neoadjuvant sequential treatment with exemestane and anastrozole in post-menopausal women with hormone receptor-positive breast cancer.

Author: FreedmanO C, AmirE, HannaW, KahnH, O'MalleyF, DranitsarisG, ColeD E C, VermaS, FolkerdE, DowsettM, ClemonsM

Breast cancer

Aromatase inhibitors are drugs used to treat breast cancer. This study compared two types of aromatase inhibitors, exemestane (steroidal) and anastrozole (non-steroidal), in postmenopausal women. The researchers found that the order in which these drugs were used had little impact on outcomes. Most patients preferred anastrozole over exemestane, suggesting that patient preference should be considered in treatment decisions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Long-term endometrial effects in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES)--a randomised controlled trial of exemestane versus continued tamoxifen after 2-3 years tamoxifen.

Author: BertelliG, HallE, IrelandE, SnowdonC F, JassemJ, DrosikK, Karnicka-MlodkowskaH, CoombesR C, BlissJ M

Breast cancer
Uterine abnormalities

Tamoxifen, a common breast cancer drug, can have estrogen-like effects on the uterus. Aromatase inhibitors (AIs) are increasingly used after tamoxifen to reduce these effects. The study suggests that AIs may help to prevent uterine problems caused by tamoxifen.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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