Aromasin

Exemestane is an irreversible, steroidal aromatase inhibitor. Exemestane is used in postmenopausal women as second-line hormonal therapy of advanced breast cancer and as adjuvant therapy in postmenopausal women with estrogenreceptor positive early breast cancer. An advantage of exemestane is the lack of cross-resistance with other non-steroidal aromatase inhibitors, anastrazole and letrozole, and tamoxifen; patients whose breast cancer progresses while receiving these agents may still respond to exemestane. Exemestane produces more complete estrogen blockade than anastrazole or letrozole. In comparison to megestrol in postmenopausal women with advanced breast cancer, exemestane achieved a similar objective response rate as megestrol, but the time to tumor progression and survival was significantly prolonged with exemestane. In a subset of patients with visceral disease (lung and liver involvement), exemestane achieved higher overall response rates and survival than megestrol. In addition, exemestane caused less weight gain than megestrol. Aromatase inhibitors are considered to be a standard of therapy and drug class of choice for the treatment of early breast cancer in postmenopausal women with hormone-receptor positive disease. The American Society of Clinical Oncology recommends that all postmenopausal women with hormone receptor-positive early breast cancer receive adjuvant aromatase inhibitor therapy. Options include 5 years of an aromatase inhibitor or sequential therapy with 2—3 years or 5 years of tamoxifen followed by 2—3 years or 5 years of an aromatase inhibitor. The optimal duration of therapy and regimen are not known. The FDA approved exemestane for the treatment of advanced breast cancer in postmenopausal women who have progressed on tamoxifen therapy in October 1999. In October 2005, exemestane was approved as adjuvant hormonal therapy in postmenopausal women with estrogen-receptor positive early breast cancer. Specifically, women who have received 2—3 years of tamoxifen therapy can be switched to exemestane for the completion of a total of five years of adjuvant hormonal therapy.

Side effects:

• hot flashes
• fast breathing
• aching/painful joints and muscles
• headache
• unusual sweating
• weight gain
• nausea
• diarrhea
• tiredness
• dizziness
• trouble sleeping and vomiting may occur

If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

• weak/painful wrists
• tingling/numbness of hands/feet
• hair loss
• mental/mood changes (depression, anxiety)
• fever

Seek immediate medical attention if any of these rare but very serious side effects occur:

• chest pain
• nausea with unusual sweating
• sudden and severe headache
• sudden fainting
• sudden weakness/paralysis on one side of the body
• leg swelling/redness/pain

A very serious allergic reaction to this drug is unlikely, but seek immediate
medical attention if it occurs. Symptoms of a serious allergic reaction may
include:

• rash
• itching
• swelling (especially of any part of the face/neck)
• severe dizziness
• trouble breathing