July 21, 2014
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Extended neoadjuvant exemestane improved outcomes in ER-positive breast cancer

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Postmenopausal women with strong ER-positive breast cancer treated with neoadjuvant exemestane demonstrated superior outcomes after 6 months of treatment than they did at 3 months, according to results of a multicenter phase 2 trial.

The use of neoadjuvant hormonal therapy is becoming more common in breast cancer management and prior studies have suggested it improves surgical outcomes among postmenopausal women with ER-positive breast cancer. However, no consensus exists with regard to the ideal duration of neoadjuvant hormonal therapy, according to background information provided by researchers.

Duveken B.Y. Fontein, MD, of the department of surgery at Leiden University Medical Center in the Netherlands, and colleagues conducted the TEAM IIA trial to assess the efficacy of 6 months of neoadjuvant exemestane in postmenopausal women with strong ER-positive disease (≥50%).

PFS at 3 months and 6 months served as the primary endpoint. Radiologic response measured by MRI, mammography or ultrasound served as a secondary endpoint.

The analysis included 102 patients (median age, 72 years; range, 53-88).

Sixty-three patients underwent palpation measurements at 3 months and >3 months. Researchers calculated an overall response rate of 58.7% at 3 months and 68.3% at their final palpation measurement.

Mean tumor size at baseline was 39.1 mm (95% CI, 34.8-43.4), and it declined to 23 mm (95% CI, 18.7-27.2) at 3 months and 16.7 mm (95% CI, 12.6-20.8) at final palpation >3 months (P=.001).

Final radiological response rates after treatment were 70.3% for MRI (n=37), 48.2% for mammography (n=56) and 41.6% for ultrasound (n=77).

Four patients experienced disease progression during exemestane treatment. However, overall, researchers determined the feasibility of breast conservation improved by almost 10%.

Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.