Exemestane as primary treatment of oestrogen receptor-positive breast cancer in postmenopausal women: a phase II trial

被引:28
|
作者
Barnadas, A. [1 ]
Gil, M. [2 ]
Gonzalez, S. [3 ]
Tusquets, I. [4 ]
Munoz, M. [5 ]
Arcusa, A. [6 ]
Prieto, L. [7 ]
Margeli-Vila, M. [8 ]
Moreno, A. [9 ]
机构
[1] Hosp Badalona Germans Trias & Pujol, Dept Med Oncol, Inst Catala Oncol, Badalona, Spain
[2] Hosp Duran & Reynals, Dept Med Oncol, Inst Catala Oncol IDIBELL, Lhospitalet De Llobregat, Spain
[3] Hosp Mutua Terrassa, Dept Med Oncol, Terrassa, Spain
[4] Hosp del Mar, Dept Med Oncol, Barcelona, Spain
[5] Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain
[6] Consorcio Sanit Terrassa, Dept Med Oncol, Terrassa, Spain
[7] Hosp Univ Bellvitge, Dept Radiodiag, Lhospitalet De Llobregat, Spain
[8] Hosp Badalona Germans Trias & Pujol, Dept Med Oncol, Inst Catala Oncol, Badalona, Spain
[9] Hosp Univ Bellvitge, Dept Pathol Anat, Lhospitalet De Llobregat, Spain
关键词
aromatase inhibitors; breast cancer; exemestane; neoadjuvant therapy; primary hormonal therapy; TERM-FOLLOW-UP; ELDERLY-PATIENTS; PRIMARY CHEMOTHERAPY; NEOADJUVANT TREATMENT; TAMOXIFEN THERAPY; TREATMENT CHOICE; INITIAL THERAPY; SURGERY; MASTECTOMY; LETROZOLE;
D O I
10.1038/sj.bjc.6604868
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To assess the efficacy of exemestane as neoadjuvant treatment, 55 postmenopausal women ( mean age: 76 years; range: 66-86) with oestrogen-positive non-metastatic breast tumour and ineligible for conservative surgery were recruited into this phase II trial to receive oral exemestane ( 25 mg day(-1)) for 6 months. Tumour response was evaluated by clinical examination, mammography and breast ultrasound every 2 months (RECIST criteria). Overall clinical response to treatment was observed in 33/54 patients (61.1%; 95% CI: 48.1-74.0). Radiological responses in 45 evaluable patients were partial response in 23, stable disease in 21 and disease progression in one. Median time to surgery from the commencement of treatment was 7 months; conservative surgery in 24 patients (55.8%) and mastectomy in 19 patients (34.5%); no surgery ( patient choice or considered not suitable by attending physician) in 12 patients. Pathologic complete response was observed in breast and axilla in one patient (2.3%) and different forms of persistent disease in 23 (53.5%) patients. Treatment tolerance was good. No patient withdrew from the study because of toxic events. We conclude that exemestane as a primary treatment is feasible and very active in elderly patients with large-sized breast cancer tumour. Conservative surgery is feasible in responding patients. No severe adverse events were detected. The optimal hormonal treatment schedule remains to be determined.
引用
收藏
页码:442 / 449
页数:8
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