Exemestane Use in Postmenopausal Women at High Risk for Invasive Breast Cancer: Evaluating Biomarkers of Efficacy and Safety

This phase II trial evaluated clinical markers of efficacy and safety of exemestane in postmenopausal women at increased risk for breast cancer. Postmenopausal women (n = 42) at risk for invasive breast cancer received 25 mg exemestane daily for 2 years along with calcium and vitamin D. The primary...

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Published in:Cancer prevention research (Philadelphia, Pa.) Pa.), 2016-03, Vol.9 (3), p.225-233
Main Authors: Gatti-Mays, Margaret E, Venzon, David, Galbo, Claudia E, Singer, Andrea, Reynolds, James, Makariou, Erini, Kallakury, Bhaskar, Heckman-Stoddard, Brandy M, Korde, Larissa, Isaacs, Claudine, Warren, Robert, Gallagher, Ann, Eng-Wong, Jennifer
Format: Article
Language:English
Subjects:
Androstadienes - therapeutic use
Aromatase Inhibitors - therapeutic use
Biomarkers, Tumor - metabolism
Bone Density - drug effects
Breast Density - drug effects
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Female
Follow-Up Studies
Humans
Immunoenzyme Techniques
Lipids - analysis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Postmenopause
Prognosis
Quality of Life
Risk Factors
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Summary:This phase II trial evaluated clinical markers of efficacy and safety of exemestane in postmenopausal women at increased risk for breast cancer. Postmenopausal women (n = 42) at risk for invasive breast cancer received 25 mg exemestane daily for 2 years along with calcium and vitamin D. The primary outcome was change in mammographic density (MD) after one year. Secondary outcomes included change in serum steroid hormones as well as change in trefoil protein 1 (TFF1) and proliferating cell nuclear antigen (PCNA) in breast tissue. Safety and tolerability were also assessed. MD decreased at 1 year and was significant at 2 years [mean change = -4.1%; 95% confidence intervals (CI), -7.2 to -1.1; P = 0.009]. Serum estradiol and testosterone levels significantly decreased at 3 months and remained suppressed at 12 months. After 1 year of treatment, TFF1 intensity decreased (mean change -1.32; 95% CI, -1.87 to -0.76; P < 0.001). Exemestane was safe and well tolerated. Exemestane decreased MD and expression of breast tissue TFF1. It was well tolerated with few clinically relevant side effects. MD and breast tissue TFF1 are potential biomarkers of breast cancer-preventive effects of exemestane in high-risk postmenopausal women.
ISSN:1940-6207
1940-6215
DOI:10.1158/1940-6207.CAPR-15-0269