Exemestane in the Treatment of Postmenopausal Women with Breast Cancer: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

CHENG Kai ^1,2 , XU Ting ² , HU Haibo ^1,2 ,  TANG Yao ²

1. West China School of Pharmacy, Sichuan University, Chengdu 610041, China;2. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

TANG Yao, Email: nedvedfsk@163.com

Keywords：

Exemestane; Breast cancer; Systematic review

DOI：

10.7507/1672-2531.20090219

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the effectiveness of exemestane in the treatment of postmenopausal women with breast cancer.
Methods 　We searched The Cochrane Library, PubMed, CBMdisc, and CNKI to identify randomized controlled trials (RCTs) that met the inclusion and exclusion criteria. Two reviewers extracted the data and evaluated the quality of included trials, respectively. Meta-analysis was performed using RevMan 5.0 software.
Results 　A total of 12 RCTs involving 6 166 participants were included, and the results of meta-analyses showed that: (1) When used in neoadjuvant endocrine therapy after operation, exemestane was more effective in progression-free survival than tamoxifen; (2) When used in rescue therapy, exemestane was more effective in objective response than tamoxifen, but not more effective than letrozole or anastrozole; (3) When used in new neoadjuvant endocrine therapy before operation, exemestane was not more effective than letrozole, and there was too little research about it.
Conclusions 　The current evidence shows that exemestane has certain short-term therapeutic effect, but its long-term therapeutic effect is unknown. More high-quality clinical trials are expected for further study.

Citation： CHENG Kai,XU Ting,HU Haibo,TANG Yao. Exemestane in the Treatment of Postmenopausal Women with Breast Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(11): 1220-1225. doi: 10.7507/1672-2531.20090219 Copy

1.	吴在德, 吴肇汉, 郑树, 等. 外科学. 第6版. 北京: 人民卫生出版社, 2004, 327-330.
2.	王充顺, 刘军, 庞宏欣. 乳腺癌内分泌治疗进展. 现代肿瘤医学, 2009, 17(1): 174-176.
3.	闫敏, 江泽飞, 宋三泰, 等. 芳香化酶抑制剂治疗乳腺癌研究进展. 国外医学肿瘤学册, 2003, 30(2):125.
4.	陈国广, 陈王景, 万红贵, 等. 新型抗肿瘤药物依西美坦. 中国新药杂志, 2003, 12(3):182-185.
5.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions. 2008, Part2: Table 8.5.c.
6.	Paridaens RJ, Dirix LY, Beex LV, et al. Phase III study comparing exemestane with tamoxifen as first-line hormonal treat- ment of metastatic breast cancer in postmenopausal women: the European Organisation for Research and Treatment of Cancer Breast Cancer Cooperative Group. J Clin Oncol, 2008, 26(30): 4883-4890.
7.	Coombes RC, Kilbum LS, Snowdon CF, et al. Survival and safety of exemestane versus tamoxifen after 2-3 years’ tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet, 2007, 17(369): 559-570.
8.	Semiglazov V, Kletsel A, Semiglazov V, et al. exemestane (E) vs tamoxifen (T) as neoadjuvant endocrine therapy for postmenopausal women with ER+ breast cancer (T2N1-2, T3N0-1, T4N0-M0). J Clin Oncol, 2005, 23(16 Suppl): 11S.
9.	Paridaens R, Dirix L, Lohrisch C, et al. Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer. Ann Oncol, 2003, 14(9): 1391-1398.
10.	Chow LW. Celecoxib anti-aromatase neoadjuvant (CAAN) trial for locally advanced breast cancer. J Steroid Biochem Mol Biol, 2008, 111(1-2): 13-17.
11.	国虹, 陈亮, 张博, 等. 依西美坦治疗绝经后晚期乳腺癌Ⅱ期临床观察. 中国医刊, 2008, 43(1): 45-46.
12.	王华庆, 任长才, 冯威健, 等. 依西美坦治疗晚期转移性乳腺癌195 例多中心随机对照研究. 中华医学杂志, 2003, 83(3): 188-190.
13.	王秀问, 黎莉. 国产依西美坦治疗绝经后晚期乳腺癌的Ⅱ期临床试验研究. 山东大学学报, 2003. 41(4): 418-420.
14.	黎治平, 钟睿, 马行天, 等. 依西美坦治疗绝经后妇女晚期乳腺的临床疗效观察. 实用癌症杂志, 2007, 17(5): 542-544.
15.	郑弘宇, 黄萍, 张其忠, 等. 依西美坦片治疗绝经后晚期乳腺癌Ⅱ期临床研究. 实用医学杂志, 2002, 18(10): 1108-1110.
16.	周文献, 胡晓桦, 宋向群, 等. 依西美坦治疗绝经后晚期乳腺癌Ⅱ期临床试验. 医学文选, 2002, 21(5): 587-590.
17.	Mayordomo J, Llombart A, Martin M, et al. Randomized, multicenter, crossover phase II trial to compare exemestane (E) vs. anastrozole (A) in postmenopausal paitnets (pt) with advanced breast cancer (ABC) and positive hormone receptors (HR). Journal of Clinical Oncology, 2006, 24(18 Suppl): 37s.
18.	张象麟, 张克坚, 赖琪, 等. 药物临床信息参考2007版. 四川科学技术出版社(成都), 2007, 942-944.
19.	Gibson LJ, Dawson CL, Lawrence DJ, et al. Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women. The Cochrane Collaboration, 2007, Issue 1:1-2.
20.	王华庆, 钱正子. 乳腺癌的内分泌治疗. 中华实用内科杂志, 2007, 27(24): 1911-1913.

1. 吴在德, 吴肇汉, 郑树, 等. 外科学. 第6版. 北京: 人民卫生出版社, 2004, 327-330.
2. 王充顺, 刘军, 庞宏欣. 乳腺癌内分泌治疗进展. 现代肿瘤医学, 2009, 17(1): 174-176.
3. 闫敏, 江泽飞, 宋三泰, 等. 芳香化酶抑制剂治疗乳腺癌研究进展. 国外医学肿瘤学册, 2003, 30(2):125.
4. 陈国广, 陈王景, 万红贵, 等. 新型抗肿瘤药物依西美坦. 中国新药杂志, 2003, 12(3):182-185.
5. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions. 2008, Part2: Table 8.5.c.
6. Paridaens RJ, Dirix LY, Beex LV, et al. Phase III study comparing exemestane with tamoxifen as first-line hormonal treat- ment of metastatic breast cancer in postmenopausal women: the European Organisation for Research and Treatment of Cancer Breast Cancer Cooperative Group. J Clin Oncol, 2008, 26(30): 4883-4890.
7. Coombes RC, Kilbum LS, Snowdon CF, et al. Survival and safety of exemestane versus tamoxifen after 2-3 years’ tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet, 2007, 17(369): 559-570.
8. Semiglazov V, Kletsel A, Semiglazov V, et al. exemestane (E) vs tamoxifen (T) as neoadjuvant endocrine therapy for postmenopausal women with ER+ breast cancer (T2N1-2, T3N0-1, T4N0-M0). J Clin Oncol, 2005, 23(16 Suppl): 11S.
9. Paridaens R, Dirix L, Lohrisch C, et al. Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer. Ann Oncol, 2003, 14(9): 1391-1398.
10. Chow LW. Celecoxib anti-aromatase neoadjuvant (CAAN) trial for locally advanced breast cancer. J Steroid Biochem Mol Biol, 2008, 111(1-2): 13-17.
11. 国虹, 陈亮, 张博, 等. 依西美坦治疗绝经后晚期乳腺癌Ⅱ期临床观察. 中国医刊, 2008, 43(1): 45-46.
12. 王华庆, 任长才, 冯威健, 等. 依西美坦治疗晚期转移性乳腺癌195 例多中心随机对照研究. 中华医学杂志, 2003, 83(3): 188-190.
13. 王秀问, 黎莉. 国产依西美坦治疗绝经后晚期乳腺癌的Ⅱ期临床试验研究. 山东大学学报, 2003. 41(4): 418-420.
14. 黎治平, 钟睿, 马行天, 等. 依西美坦治疗绝经后妇女晚期乳腺的临床疗效观察. 实用癌症杂志, 2007, 17(5): 542-544.
15. 郑弘宇, 黄萍, 张其忠, 等. 依西美坦片治疗绝经后晚期乳腺癌Ⅱ期临床研究. 实用医学杂志, 2002, 18(10): 1108-1110.
16. 周文献, 胡晓桦, 宋向群, 等. 依西美坦治疗绝经后晚期乳腺癌Ⅱ期临床试验. 医学文选, 2002, 21(5): 587-590.
17. Mayordomo J, Llombart A, Martin M, et al. Randomized, multicenter, crossover phase II trial to compare exemestane (E) vs. anastrozole (A) in postmenopausal paitnets (pt) with advanced breast cancer (ABC) and positive hormone receptors (HR). Journal of Clinical Oncology, 2006, 24(18 Suppl): 37s.
18. 张象麟, 张克坚, 赖琪, 等. 药物临床信息参考2007版. 四川科学技术出版社(成都), 2007, 942-944.
19. Gibson LJ, Dawson CL, Lawrence DJ, et al. Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women. The Cochrane Collaboration, 2007, Issue 1:1-2.
20. 王华庆, 钱正子. 乳腺癌的内分泌治疗. 中华实用内科杂志, 2007, 27(24): 1911-1913.

Chinese Journal of Evidence-Based Medicine

Exemestane in the Treatment of Postmenopausal Women with Breast Cancer: A Systematic Review

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