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TEAM: Exemestane safer, more effective than tamoxifen for breast cancer

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ECCO 15 – ESMO 34 Multidisciplinary Congress

Adjuvant therapy with exemestane was safer and more effective than tamoxifen in reducing breast cancer recurrence in high-risk patients, according to findings from a phase-3 trial presented at the ECCO 15 – ESMO 34 Multidisciplinary Congress, held in Berlin.

Cornelis van de Velde, MD, PhD, professor of surgery at Leiden University Medical Center in the Netherlands, and colleagues analyzed data from 9,779 women from Belgium, France, Germany, Greece, Japan, the Netherlands, the United Kingdom, Ireland and the United States. Women in the TEAM trial were randomly assigned to exemestane 25 mg per day or tamoxifen 20 mg per day.

DFS improved for patients in the exemestane group compared with patients from the tamoxifen group (HR=0.89; 95% CI, 0.77-1.03). Recurrence-free survival improved also (HR=0.85; 95% CI, 0.72-1.00).

Patients in the Netherlands and Belgium had a 12% recurrence when assigned to tamoxifen and 9% recurrence when assigned to exemestane compared with all international patients assigned to tamoxifen (8%) and exemestane (7%). These findings may be a result of better compliance in the Netherlands, the researchers said in a press release.

Overall, noncompliance was 19.8% for tamoxifen and 12.9% for exemestane whereas for the Dutch/Belgian groups, noncompliance was 14% for tamoxifen and 9% for exemestane. Adverse effects accounted for 6.3% of discontinuation of tamoxifen and 4.4% of exemestane, according to van de Velde.

There were 11% fewer cases of local tumor recurrence, distant metastases, contralateral breast cancer and deaths without disease relapse for women in the exemestane group compared with the tamoxifen group.

“The current analysis covers a short period of time with relatively few deaths, and this makes it difficult to see significant difference between the two groups,” van de Velde said in a press release. “However, the data from TEAM indicate that early use of exemestane in these high-risk patients appears to be safe and a more effective endocrine treatment than tamoxifen for reducing breast cancer recurrence.”

For more information:

• Velde van de C. #2BA. Presented at: ECCO 15 and 34th ESMO Multidisciplinary Congress; Sept. 20-24, 2009; Berlin.

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