Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 530
© 2005 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Semiglazov, V. Articles by Berstein, L. Search for Related Content PubMed Articles by Semiglazov, V. Articles by Berstein, L.

Abstract

Exemestane (E) vs tamoxifen (T) as neoadjuvant endocrine therapy for postmenopausal women with ER+ breast cancer (T2N1–2, T3N0–1, T4N0M0)

NN Petrov Research Inst of Oncology, St Petersberg, Russian Federation; Universitats-Frauenklinik, Osnabruck, Germany

530

Background: There is considerable evidence that aromatase inhibitors are superior to T as first line endocrine therapy for metastatic disease. E an aromatase inactivator, is effective in women whose tumor has progressed despite T therapy. Methods: 151 PM women with ER+ breast cancer (BC) were randomly assigned once-daily treatment with either E alone 25 mg (n=76), or T alone (n=75) for 3 months. The primary endpoint was clinical objective response (OR). Secondary endpoints were OR determined by mammography and ultrasound, and number of pts who underwent breast conserving surgery (BCS). Result: Clinical, mammography, BCS rate are shown in the table. A pathological CR was shown in two pts in the E group and 2 pts in the T group. Response to any type of endocrine treatment was more likely in pts with higher levels of ER expression. Median time to response was 57 days in the E group and 70 days in the T group (p<0.05). All pts with disease progression after endocrine treatment were recommended to receive chemotherapy AT (doxorubicine 60 mg/m² + paclitaxel 200 mg/m², every 3 weeks to 4 cycles). Clinical OR after chemotherapy (second line neoadjuvant treatment) was 59.6%. During 50 months of follow up local recurrences were detected in 5.2% pts of E group and 8% pts in T group (p>0.05). 3-year disease free survival rates were 78.9% in E group and 74.6% in T group (p>0.05). Conclusion: E is more effective than T as neoadjuvant therapy for PM pts with ER+ tumors in rate of clinical OR and BCS.

View larger version (9K): [in this window] [in a new window]

Abstract presentation from the 2005 ASCO Annual Meeting