PMID- 22865782
OWN - NLM
STAT- MEDLINE
DCOM- 20130619
LR  - 20240229
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 23
IP  - 12
DP  - 2012 Dec
TI  - Relationship between specific adverse events and efficacy of exemestane therapy 
      in early postmenopausal breast cancer patients.
PG  - 3091-3097
LID - S0923-7534(19)37489-7 [pii]
LID - 10.1093/annonc/mds204 [doi]
AB  - BACKGROUND: Many adverse events (AEs) associated with aromatase inhibitors (AIs) 
      involve symptoms related to the depletion of circulating estrogens, and may be 
      related to efficacy. We assessed the relationship between specific AEs [hot 
      flashes (HF) and musculoskeletal AEs (MSAE)] and survival outcomes in Dutch and 
      Belgian patients treated with exemestane (EXE) in the Tamoxifen Exemestane 
      Adjuvant Multinational (TEAM) trial. Additionally, the relationship between 
      hormone receptor expression and AEs was assessed. METHODS: Efficacy end points 
      were relapse-free survival (RFS), overall survival (OS) and breast 
      cancer-specific mortality (BCSM), starting at 6 months after starting EXE 
      treatment. AEs reported in the first 6 months of treatment were included. 
      Specific AEs comprised HF and/or MSAE. Landmark analyses and Cox proportional 
      hazards models assessed survival differences up to 5 years. RESULTS: A total of 
      1485 EXE patients were included. Patients with HF had a better RFS than patients 
      without HF [multivariate hazard ratio (HR) 0.393, 95% confidence interval (CI) 
      0.19-0.813; P = 0.012]. The occurrence of MSAE versus no MSAE did not relate to 
      better RFS (multivariate HR 0.677, 95% CI 0.392-1.169; P = 0.162). Trends were 
      maintained for OS and BCSM. Quantitative hormone receptor expression was not 
      associated with specific AEs. CONCLUSIONS: Some AEs associated with estrogen 
      depletion are related to better outcomes and may be valuable biomarkers in AI 
      treatment.
FAU - Fontein, D B Y
AU  - Fontein DBY
AD  - Department of Surgery, Leiden University Medical Center, Leiden.
FAU - Houtsma, D
AU  - Houtsma D
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden.
FAU - Hille, E T M
AU  - Hille ETM
AD  - Department of Surgery, Leiden University Medical Center, Leiden.
FAU - Seynaeve, C
AU  - Seynaeve C
AD  - Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, 
      Rotterdam.
FAU - Putter, H
AU  - Putter H
AD  - Department of Medical Statistics, Leiden University Medical Center, Leiden.
FAU - Meershoek-Klein Kranenbarg, E
AU  - Meershoek-Klein Kranenbarg E
AD  - Department of Surgery, Leiden University Medical Center, Leiden.
FAU - Guchelaar, H J
AU  - Guchelaar HJ
AD  - Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 
      Leiden, The Netherlands.
FAU - Gelderblom, H
AU  - Gelderblom H
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden.
FAU - Dirix, L Y
AU  - Dirix LY
AD  - St Augustinus Hospital, Wilrijk.
FAU - Paridaens, R
AU  - Paridaens R
AD  - UZ Gasthuisberg, Leuven, Belgium.
FAU - Bartlett, J M S
AU  - Bartlett JMS
AD  - Ontario Institute for Cancer Research, Toronto, Canada; Department of Pathology, 
      University of Edinburgh, Edinburgh, UK.
FAU - Nortier, J W R
AU  - Nortier JWR
AD  - Department of Medical Oncology, Leiden University Medical Center, Leiden.
FAU - van de Velde, C J H
AU  - van de Velde CJH
AD  - Department of Surgery, Leiden University Medical Center, Leiden. Electronic 
      address: c.j.h.van_de_velde@lumc.nl.
CN  - Dutch TEAM Steering Committee
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120802
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 0 (Androstadienes)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Aromatase Inhibitors)
RN  - NY22HMQ4BX (exemestane)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Androstadienes/*adverse effects/*therapeutic use
MH  - Antineoplastic Agents/adverse effects/therapeutic use
MH  - Aromatase Inhibitors/*adverse effects/*therapeutic use
MH  - *Breast Neoplasms/drug therapy/mortality/pathology
MH  - Chemotherapy, Adjuvant
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Postmenopause
MH  - Treatment Outcome
EDAT- 2012/08/07 06:00
MHDA- 2013/06/20 06:00
CRDT- 2012/08/07 06:00
PHST- 2012/08/07 06:00 [entrez]
PHST- 2012/08/07 06:00 [pubmed]
PHST- 2013/06/20 06:00 [medline]
AID - S0923-7534(19)37489-7 [pii]
AID - 10.1093/annonc/mds204 [doi]
PST - ppublish
SO  - Ann Oncol. 2012 Dec;23(12):3091-3097. doi: 10.1093/annonc/mds204. Epub 2012 Aug 
      2.