Tamoxifen and raloxifene reduce the risk of breast cancer in women at high risk for this disease. A third drug, exemestane, an aromatase inhibitor, is now on the market. A study, partly funded by the pharmaceutical industry, investigated 4,560 postmenopausal women who met at least one of the following inclusion criteria: 1. age ≥ 60; 2. 5-year risk score greater than 1.66%; 3. prior intraepithelial neoplasia. Patients were randomly administered exemestane for 5 years, with scheduled annual clinical assessments and mammography. During a 3-year median follow-up period, invasive breast cancer developed in 11 women treated with exemestane, and in 32 women treated with placebo (annual incidence 0.19% vs. 0.55%). Hot flashes and arthralgia were slightly more frequent in patients using the drug than in those using placebo, while skeletal fracture and cardiovascular events were similar in both groups. Approximately one third of patients from both groups discontinued the treatment early, the majority being in the exemestane group due to toxic effects (15.4% in this group vs. 10.8% in the placebo group).
(Oncology)
Our comment:
December 2011
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