Drug safety evaluation of exemestane

Expert Opinion on Drug Safety

Volumn 10, Issue 3, 2011, Pages 473-487

  Lintermans, Anneleen ^a   Neven, Patrick ^a   Paridaens, Robert ^a  

^a UNIVERSITY OF LEUVEN   (Belgium)

Author keywords

breast cancer; exemestane; IES; TEAM

Indexed keywords

ANASTROZOLE; AROMATASE INHIBITOR; CELECOXIB; CLOMIFENE CITRATE; CYCLOOXYGENASE 2 INHIBITOR; CYCLOPHOSPHAMIDE; DOXORUBICIN; EXEMESTANE; FLUOROURACIL; FULVESTRANT; GONADORELIN AGONIST; LETROZOLE; LEUPRORELIN; MEGESTROL ACETATE; PLACEBO; RIFAMPICIN; TAMOXIFEN; TRIPTORELIN;

AREA UNDER THE CURVE; ARTHRALGIA; ARTICLE; BONE METABOLISM; BREAST CANCER; CANCER MORTALITY; CANCER PREVENTION; CARPAL TUNNEL SYNDROME; CHOLESTEROL BLOOD LEVEL; CLINICAL TRIAL (TOPIC); COGNITION; DIARRHEA; DISEASE FREE SURVIVAL; DRUG ABSORPTION; DRUG ANTAGONISM; DRUG DISTRIBUTION; DRUG EFFICACY; DRUG EXCRETION; DRUG HALF LIFE; DRUG MECHANISM; DRUG METABOLISM; DRUG PROTEIN BINDING; DRUG SAFETY; DRUG TOLERABILITY; DRUG TREATMENT FAILURE; DRUG WITHDRAWAL; ENDOMETRIOSIS; ENDOMETRIUM CANCER; ETHNICITY; FATIGUE; FRACTURE; HEART DEATH; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HOT FLUSH; HUMAN; INSOMNIA; JOINT STIFFNESS; KIDNEY DISEASE; LEIOMYOSARCOMA; LIBIDO DISORDER; LIVER DISEASE; MAXIMUM TOLERATED DOSE; METASTASIS; MUSCULOSKELETAL PAIN; NONHUMAN; OSTEOPENIA; OSTEOPOROSIS; OVARIECTOMY; OVARY CANCER; OVARY POLYCYSTIC DISEASE; PARESTHESIA; PERITONEUM CANCER; POSTMENOPAUSE; PREMENOPAUSE; QUALITY OF LIFE; SEX DIFFERENCE; SIDE EFFECT; SINGLE DRUG DOSE; TIME TO MAXIMUM PLASMA CONCENTRATION; TREATMENT RESPONSE; TRIACYLGLYCEROL BLOOD LEVEL; UTERUS MYOMA; VAGINAL DRYNESS; VISUAL DISORDER;

ANDROSTADIENES; ANIMALS; AROMATASE INHIBITORS; BREAST NEOPLASMS; CLINICAL TRIALS AS TOPIC; FEMALE; HUMANS;

EID: 79955418867     PISSN: 14740338     EISSN: None     Source Type: Journal    
DOI: 10.1517/14740338.2011.567264     Document Type: Article

References (105)

1. Coombes R, Hall E, Gibson L, et al. A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 2004;350:1081-92 (Pubitemid 38298988)
2. Howell A, Cuzick J, Baum M, et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years adjuvant treatment for breast cancer. Lancet 2005;365:60-2
3. Goss P, Ingle J, Martino S, et al. Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer: updated findings from NCIC CTG MA.17. J Natl Cancer Inst 2005;97:1262-71 (Pubitemid 41535367)
4. Nabholtz JM, Mouret-Reynier MA, Durando X, et al. Comparative review of anastrozole, letrozole and exemestane in the management of early breast cancer. Expert Opin Pharmacother 2009;10:1435-47
5. Poole R, Paridaens R. The use of third-generation aromatase inhibitors and tamoxifen in the adjuvant treatment of postmenopausal patients with hormone-dependent breast cancer: evidence based review. Curr Opin Oncol 2007;19:564-72
6. Cole P, Robinson C. Mechanism and inhibition of cytochrome P-450 aromatase. J Med Chem 1990;33:2933-42 (Pubitemid 20349513)
7. di Salle E, Ornati G, Giudici D, et al. Exemestane (FCE 24304), a new steroidal aromatase inhibitor. J Steroid Biochem Mol Biol 1992;43:137-43
8. Hong Y, Yu B, Sherman M, et al. Molecular basis for the aromatization reaction and exemestane-mediated irreversible inhibition of human aromatase. Mol Endocrinol 2007;21:401-14 (Pubitemid 46184893)
9. Wang X, Chen S. Aromatase destabilizer: novel action of exemestane, a food and drug administration-approved aromatase inhibitor. Cancer Res 2006;66:10281-6 (Pubitemid 44799745)
10. Ariazi E, Leitao A, Oprea T, et al. Exemestanes 17-hydroxylated metabolite exerts biological effects as an androgen. Mol Cancer Ther 2007;6:2817-27 (Pubitemid 350206762)
11. Bertelli G, Paridaens R. Optimal sequence of hormonotherapy in advanced breast cancer. Curr Opin Oncol 2006;18:572-7 (Pubitemid 44427630)
12. Paridaens R, Thomas J, Wildiers J, et al. Safety, activity and estrogen inhibition by exemestane in postmenopausal women with advanced breast cancer: a phase I study. Anticancer Drugs 1998;9:675-83 (Pubitemid 28495452)
13. Miller W. Aromatase inhibitors: mechanism of action and role in the treatment of breast cancer. Semin Oncol 2003;30:3-11 (Pubitemid 37169769)
14. Valle M, Di Salle E, Jannuzzo MG, et al. A predictive model for exemestane pharmacokinetics/pharmacodynamics incorporating the effect of food and formulation. Br J Clin Pharmacol 2005;59:355-64 (Pubitemid 40388090)
15. Roberts J, Tumer N. Age and diet effects on drug action. Pharmacol Ther 1988;37:111-49 (Pubitemid 18078205)
16. Hutson P, Love R, Havighurst T, et al. Effect of exemestane on tamoxifen pharmacokinetics in postmenopausal women treated for breast cancer. Clin Cancer Res 2005;11:8722-7 (Pubitemid 43005922)
17. Jannuzzo M, Poggesi I, Spinelli R, et al. The effects of degree of hepatic or renal impairment on the pharmacokinetics of exemestane in postmenopausal women. Cancer Chemother Pharmacol 2004;53:475-81 (Pubitemid 38680244)
18. Aromasin- (exemestane) tablets [prescribing information]. Revised October. 2008. Pfizer, Inc. NY: NY. Available from: http://www.pfizerpro. com/resources/minisites/oncology/ aromasin/pi/full-prescribingkinformation. Pdf.
19. Dixon J. Exemestane and aromatase inhibitors in the management of advanced breast cancer. Expert Opin Pharmacother 2004;5:307-16 (Pubitemid 38219857)
20. Bliss JM, Kilburn LS, Coleman RE, et al. Disease related outcome with long term follow-up: an updated analysis of the Intergroup Exemestane Study (IES) [oral presentation]. Presented at San Antonio Breast Cancer Symposium; San Antonio, TX; 2009
21. Coombes RC, Kilburn LS, Beare SL, et al. Survival and safety post study treatment completion: an updated analysis of the Intergroup Exemestane Study (IES) [oral presentation]. Presented at Joint ECCO 15 - 34th ESMO Multidisciplinary Congress; Berlin, Germany; 2009
22. Coombes RC, Kilburn LS, Snowdon CF, et al. Survival and safety of exemestane versus tamoxifen after 2-3 years tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet 2007;369:559-70
23. Goss PE, Ingle JN, Chapman J-AW, et al. Final analysis of NCIC CTG MA.27: a randomized phase III trial of exemestane versus anastrozole in postmenopausal women with hormone receptor positive primary breast cancer [abstract S1-1]. Presented at San Antonio Breast Cancer Symposium; San Antonio, TX; 2010
24. Mamounas E, Jeong J, Wickerham D, et al. Benefit from exemestane as extended adjuvant therapy after 5 years of adjuvant tamoxifen: intention-to-treat analysis of the National Surgical Adjuvant Breast And Bowel Project B-33 trial. J Clin Oncol 2008;26:1965-71
25. Rea D, Hasenburg A, Seynaeve C, et al. Five years of exemestane as initial therapy compared to tamoxifen followed by exemestane for five years: the TEAM trial, a prospective, randomized, phase III trial in postmenopausal women with hormone-sensitive early breast cancer [oral presentation]. Presented at San Antonio Breast Cancer Symposium; San Antonio, TX; 2009
26. van de Velde CJ, Rea D, Seynaeve C, et al. Adjuvant tamoxifen and exemestane in early breast cancer (TEAM): a randomised phase 3 trial. Lancet 2011;377:321-31
27. Takei H, Suemasu K, Inoue K, et al. Multicenter phase II trial of neoadjuvant exemestane for postmenopausal patients with hormone receptor-positive, operable breast cancer: Saitama Breast Cancer Clinical Study Group (SBCCSG-03). Breast Cancer Res Treat 2008;107:87-94 (Pubitemid 350179589)
28. Barnadas A, Gil M, Gonzalez S, et al. Exemestane as primary treatment of oestrogen receptor-positive breast cancer in postmenopausal women: a phase II trial. Br J Cancer 2009;100:442-9
29. Ellis MJ. ACOSOG Z1031: a randomized phase II trial comparing exemestane, letrozole, and anastrozole in postmenopausal women with clinical stage II/III estrogen receptor-positive breast cancer. J Clin Oncol 2010;28:abstract LBA513
30. Freedman O, Amir E, Hanna W, et al. A randomized trial exploring the biomarker effects of neoadjuvant sequential treatment with exemestane and anastrozole in post-menopausal women with hormone receptor-positive breast cancer. Breast Cancer Res Treat 2010;119:155-61
31. Paridaens RJ, Dirix LY, Beex LV, et al. Phase III study comparing exemestane with tamoxifen as first-line hormonal treatment of metastatic breast cancer in postmenopausal women: the European Organisation for Research and Treatment of Cancer Breast Cancer Cooperative Group. J Clin Oncol 2008;26:4883-90
32. Chia S, Gradishar W, Mauriac L, et al. Double-blind, randomized placebo controlled trial of fulvestrant compared with exemestane after prior nonsteroidal aromatase inhibitor therapy in postmenopausal women with hormone receptor-positive, advanced breast cancer: results from EFECT. J Clin Oncol 2008;26:1664-70
33. Kaufmann M, Bajetta E, Dirix LY, et al. Exemestane is superior to megestrol acetate after tamoxifen failure in postmenopausal women with advanced breast cancer: results of a phase III randomized double-blind trial. The Exemestane Study Group. J Clin Oncol 2000;18:1399-411 (Pubitemid 30205385)
34. Kaufmann M, Bajetta E, Dirix LY, et al. Exemestane improves survival in metastatic breast cancer: results of a phase III randomized study. Clin Breast Cancer 2000;1(Suppl 1):S15-18
35. Steele N, Zekri J, Coleman R, et al. Exemestane in metastatic breast cancer: effective therapy after third-generation non-steroidal aromatase inhibitor failure. Breast 2006;15:430-6
36. Iaffaioli R, Formato R, Tortoriello A, et al. Phase II study of sequential hormonal therapy with anastrozole/ exemestane in advanced and metastatic breast cancer. Br J Cancer 2005;92:1621-5 (Pubitemid 40756471)
37. Gennatas C, Michalaki V, Carvounis E, et al. Third-line hormonal treatment with exemestane in postmenopausal patients with advanced breast cancer progressing on letrozole or anastrozole. A phase II trial conducted by the Hellenic Group of Oncology (HELGO). Tumori 2006;92:13-17
38. Paridaens R, Dirix L, Lohrisch C, et al. Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer. Ann Oncol 2003;14:1391-8 (Pubitemid 37185285)
39. Mauriac L, Romieu G, Bines J. Activity of fulvestrant versus exemestane in advanced breast cancer patients with or without visceral metastases: data from the EFECT trial. Breast Cancer Res Treat 2009;117:69-75
40. Dodwell D, Coombes G, Bliss JM, et al. Combining fulvestrant (Faslodex) with continued oestrogen suppression in endocrine-sensitive advanced breast cancer: the SoFEA trial. Clin Oncol (R Coll Radiol) 2008;20:321-4
41. Freedman O, Verma S, Clemons M. Pre-menopausal breast cancer and aromatase inhibitors: treating a new generation of women. Breast Cancer Res Treat 2006;99:241-7 (Pubitemid 44337915)
42. Jannuzzo M, Di Salle E, Spinelli R, et al. Estrogen suppression in premenopausal women following 8 weeks of treatment with exemestane and triptorelin versus triptorelin alone. Breast Cancer Res Treat 2009;113:491-9
43. Smith I, Dowsett M, Yap Y, et al. Adjuvant aromatase inhibitors for early breast cancer after chemotherapy-induced amenorrhoea: caution and suggested guidelines. J Clin Oncol 2006;24:2444-7 (Pubitemid 46630620)
44. de Ronde W. Therapeutic uses of aromatase inhibitors in men. Curr Opin Endocrinol Diabetes Obes 2007;14:235-40 (Pubitemid 46684479)
45. Turner K, Morley M, Atanassova N, et al. Effect of chronic administration of an aromatase inhibitor to adult male rats on pituitary and testicular function and fertility. J Endocrinol 2000;164:225-38 (Pubitemid 30114670)
46. Mauras N, OBrien K, Klein K, Hayes V. Estrogen suppression in males: metabolic effects. J Clin Endocrinol Metab 2000;85:2370-7 (Pubitemid 32269188)
47. Giordano S, Hortobagyi G. Leuprolide acetate plus aromatase inhibition for male breast cancer. J Clin Oncol 2006;24:e42-43
48. Doyen J, Italiano A, Largillier R, et al. Aromatase inhibition in male breast cancer patients: biological and clinical implications. Ann Oncol 2010;21:1243-5
49. Bonomo M, Mingrone W, Brauchli P, et al. Exemestane seems to stimulate tumour growth in men with prostate carcinoma. Eur J Cancer 2003;39:2111-12 (Pubitemid 37297771)
50. Gasco M, Argusti A, Bonanni B, Decensi A. SERMs in chemoprevention of breast cancer. Eur J Cancer 2005;41:1980-9 (Pubitemid 41557683)
51. Cuzick J. Aromatase inhibitors for breast cancer prevention. J Clin Oncol 2005;23:1636-43 (Pubitemid 46211418)
52. Macedo L, Guo Z, Tilghman S, et al. Role of androgens on MCF-7 breast cancer cell growth and on the inhibitory effect of letrozole. Cancer Res 2006;66:7775-82 (Pubitemid 44289238)
53. Polyzos N, Tzioras S, Badawy A, et al. Aromatase inhibitors for female infertility: a systematic review of the literature. Reprod Biomed Online 2009;19:456-71
54. Pirard C, Donnez J, Loumaye E. GnRH agonist as novel luteal support: results of a randomized, parallel group, feasibility study using intranasal administration of buserelin. Hum Reprod 2005;20:1798-804 (Pubitemid 40940990)
55. Noble L, Simpson E, Johns A, Bulun S. Aromatase expression in endometriosis. J Clin Endocrinol Metab 1996;81:174-9 (Pubitemid 26035021)
56. Bulun S, Zeitoun K, Takayama K, et al. Estrogen production in endometriosis and use of aromatase inhibitors to treat endometriosis. Endocr Relat Cancer 1999;6:293-301 (Pubitemid 29260065)
57. Seal SL, Kamilya G, Mukherji J, et al. Aromatase inhibitors in recurrent ovarian endometriomas: report of five cases with literature review. Fertil Steril 2011;95(1):291.e15-18
58. Mousa N, Bedaiwy M, Casper R. Aromatase inhibitors in the treatment of severe endometriosis. Obstet Gynecol 2007;109:1421-3 (Pubitemid 46869883)
59. Janni W, Hepp P. Adjuvant aromatase inhibitor therapy: outcomes and safety. Cancer Treat Rev 2010;36:249-61
60. Bertelli G, Hall E, Ireland E, et al. Long-term endometrial effects in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES)-a randomised controlled trial of exemestane versus continued tamoxifen after 2-3 years tamoxifen. Ann Oncol 2010;21:498-505
61. Morales L, Timmerman D, Neven P, et al. Third generation aromatase inhibitors may prevent endometrial growth and reverse tamoxifen-induced uterine changes in postmenopausal breast cancer patients. Ann Oncol 2005;16:70-4 (Pubitemid 40124481)
62. Kieback DG, Harbeck N, Bauer W, et al. Endometrial effects of exemestane compared to tamoxifen within the Tamoxifen Exemestane Adjuvant Multicenter (TEAM) trial: results of a prospective gynecological ultrasound substudy. Gynecol Oncol 2010;119:500-5
63. Shozu M, Murakami K, Inoue M. Aromatase and leiomyoma of the uterus. Semin Reprod Med 2004;22:51-60 (Pubitemid 38524584)
64. Bedaiwy MA, Mousa NA, Casper RF. Aromatase inhibitors: potential reproductive implications. J Minim Invasive Gynecol 2009;16:533-9
65. Bershtein LM, Danilova MA, Kovalevskii A, et al. Criteria for evaluating the effectiveness of aromatase inhibitors in the neoadjuvant treatment of patients with endometrial carcinoma. Vopr Onkol 2009;55:314-18
66. OCearbhaill R, Zhou Q, Iasonos A, et al. Treatment of advanced uterine leiomyosarcoma with aromatase inhibitors. Gynecol Oncol 2010;116:424-9
67. Ramirez PT, Schmeler KM, Milam MR, et al. Efficacy of letrozole in the treatment of recurrent platinum- and taxane-resistant high-grade cancer of the ovary or peritoneum. Gynecol Oncol 2008;110:56-9
68. Morishima A, Grumbach MM, Simpson ER, et al. Aromatase deficiency in male and female siblings caused by a novel mutation and the physiological role of estrogens. J Clin Endocrinol Metab 1995;80:3689-98
69. Dunkel L. Update on the role of aromatase inhibitors in growth disorders. Horm Res 2009;71(Suppl 1):57-63
70. Hero M, Norjavaara E, Dunkel L. Inhibition of estrogen biosynthesis with a potent aromatase inhibitor increases predicted adult height in boys with idiopathic short stature: a randomized controlled trial. J Clin Endocrinol Metab 2005;90:6396-402 (Pubitemid 41759291)
71. Jones SE, Cantrell J, Vukelja S, et al. Comparison of menopausal symptoms during the first year of adjuvant therapy with either exemestane or tamoxifen in early breast cancer: report of a Tamoxifen Exemestane Adjuvant Multicenter trial substudy. J Clin Oncol 2007;25:4765-71 (Pubitemid 350086479)
72. Fallowfield L, Bliss J, Porter L, et al. Quality of life in the intergroup exemestane study: a randomized trial of exemestane versus continued tamoxifen after 2 to 3 years of tamoxifen in postmenopausal women with primary breast cancer. J Clin Oncol 2006;24:910-17 (Pubitemid 46638844)
73. Thomas R, Williams M, Marshall C, Walker L. Switching to letrozole or exemestane improves hot flushes, mood and quality of life in tamoxifen intolerant women. Br J Cancer 2008;98:1494-9 (Pubitemid 351652326)
74. Thorne C. Management of arthralgias associated with aromatase inhibitor therapy. Curr Oncol 2007;14(Suppl 1):S11-19
75. Presant CA, Bosserman L, Young T, et al. Aromatase inhibitor-associated arthralgia and/ or bone pain: frequency and characterization in non-clinical trial patients. Clin Breast Cancer 2007;7:775-8 (Pubitemid 350086121)
76. Morales L, Pans S, Verschueren K, et al. Prospective study to assess short-term intra-articular and tenosynovial changes in the aromatase inhibitor-associated arthralgia syndrome. J Clin Oncol 2008;26:3147-52
77. Lintermans A, Van Calster B, Van Hoydonck M, et al. Aromatase inhibitor-induced loss of grip strength is body mass index dependent: hypothesis-generating findings for its pathogenesis. Ann Oncol 2011. [Epub ahead of print]
78. Henry NL, Jacobson JA, Banerjee M, et al. A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography. Cancer 2010;116:4360-7
79. Khan Q, Reddy P, Kimler B, et al. Effect of vitamin D supplementation on serum 25-hydroxy vitamin D levels, joint pain, and fatigue in women starting adjuvant letrozole treatment for breast cancer. Breast Cancer Res Treat 2010;119:111-18
80. Prieto-Alhambra D, Javaid MK, Servitja S, et al. Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study. Breast Cancer Res Treat 2011;125(3):869-78
81. Goss PE, Qi S, Josse RG, et al. The steroidal aromatase inhibitor exemestane prevents bone loss in ovariectomized rats. Bone 2004;34:384-92 (Pubitemid 38314903)
82. Coleman R, Banks L, Girgis S, et al. Skeletal effects of exemestane on bone-mineral density, bone biomarkers, and fracture incidence in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES): a randomised controlled study. Lancet Oncol 2007;8:119-27 (Pubitemid 46158372)
83. Miki Y, Suzuki T, Hatori M, et al. Effects of aromatase inhibitors on human osteoblast and osteoblast-like cells: a possible androgenic bone protective effects induced by exemestane. Bone 2007;40:876-87 (Pubitemid 46386543)
84. Geisler J, Lonning P, Krag L, et al. Changes in bone and lipid metabolism in postmenopausal women with early breast cancer after terminating 2-year treatment with exemestane: a randomised, placebo-controlled study. Eur J Cancer 2006;42:2968-75 (Pubitemid 44667475)
85. Goss P, Hadji P, Subar M, et al. Effects of steroidal and nonsteroidal aromatase inhibitors on markers of bone turnover in healthy postmenopausal women. Breast Cancer Res 2007;9:R52
86. McCloskey EV, Hannon RA, Lakner G, et al. Effects of third generation aromatase inhibitors on bone health and other safety parameters: results of an open, randomised, multi-centre study of letrozole, exemestane and anastrozole in healthy postmenopausal women. Eur J Cancer 2007;43:2523-31 (Pubitemid 350086940)
87. Atalay G, Dirix L, Biganzoli L, et al. The effect of exemestane on serum lipid profile in postmenopausal women with metastatic breast cancer: a companion study to EORTC Trial 10951, Randomized phase II study in first line hormonal treatment for metastatic breast cancer with exemestane or tamoxifen in postmenopausal patients. Ann Oncol 2004;15:211-17 (Pubitemid 38262617)
88. Markopoulos C, Chrissochou M, Michailidou A, et al. Effect of exemestane on the lipidemic profile of post-menopausal operable breast cancer patients following 5-7 years of adjuvant tamoxifen: preliminary results of the ATENA substudy. Anticancer Drugs 2005;16:879-83 (Pubitemid 41215754)
89. Markopoulos C, Polychronis A, Zobolas V, et al. The effect of exemestane on the lipidemic profile of postmenopausal early breast cancer patients: preliminary results of the TEAM Greek sub-study. Breast Cancer Res Treat 2005;93:61-6 (Pubitemid 41355992)
90. Kataja V, Hietanen P, Joensuu H, et al. The effects of adjuvant anastrozole, exemestane, tamoxifen, and toremifene on serum lipids in postmenopausal women with breast cancer - a randomised study [abstract 634]. Presented at San Antonio Breast Cancer Symposium; San Antonio, TX; 2002
91. Schilder C, Seynaeve C, Beex L, et al. Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol 2010;28:1294-300
92. Schilder CM, Eggens PC, Seynaeve C, et al. Neuropsychological functioning in postmenopausal breast cancer patients treated with tamoxifen or exemestane after AC-chemotherapy: cross-sectional findings from the neuropsychological TEAM-side study. Acta Oncol 2009;48:76-85
93. Hirshman E, Merritt P, Wang C, et al. Evidence that androgenic and estrogenic metabolites contribute to the effects of dehydroepiandrosterone on cognition in postmenopausal women. Horm Behav 2004;45:144-55 (Pubitemid 38326871)
94. Campos S, Guastalla J, Subar M, et al. A comparative study of exemestane versus anastrozole in patients with postmenopausal breast cancer with visceral metastases. Clin Breast Cancer 2009;9:39-44
95. Dowsett M, Cuzick J, Howell A, et al. Pharmacokinetics of anastrozole and tamoxifen alone, and in combination, during adjuvant endocrine therapy for early breast cancer in postmenopausal women: a sub-protocol of the Arimidex and tamoxifen alone or in combination (ATAC) trial. Br J Cancer 2001;85:317-24 (Pubitemid 32747695)
96. Ingle J, Suman V, Johnson P, et al. Evaluation of tamoxifen plus letrozole with assessment of pharmacokinetic interaction in postmenopausal women with metastatic breast cancer. Clin Cancer Res 1999;5:1642-9 (Pubitemid 29334440)
97. Jelovac D, Macedo L, Handratta V, et al. Effects of exemestane and tamoxifen in a postmenopausal breast cancer model. Clin Cancer Res 2004;10:7375-81 (Pubitemid 39487727)
98. Rivera E, Valero V, Francis D, et al. Pilot study evaluating the pharmacokinetics, pharmacodynamics, and safety of the combination of exemestane and tamoxifen. Clin Cancer Res 2004;10:1943-8 (Pubitemid 38375551)
99. Bollet MA, Kirova YM, Antoni G, et al. Responses to concurrent radiotherapy and hormone-therapy and outcome for large breast cancers in post-menopausal women. Radiother Oncol 2007;85:336-45 (Pubitemid 350213137)
100. Azria D, Larbouret C, Cunat S, et al. Letrozole sensitizes breast cancer cells to ionizing radiation. Breast Cancer Res 2005;7:R156-163
101. de la Haba-Rodriguez J, Mancha R, Manga G, et al. Exemestane and chemotherapy as first-line treatment of metastatic breast cancer: results of a phase II study. Clin Breast Cancer 2010;10:313-7
102. Albain KS, Barlow WE, Ravdin PM, et al. Adjuvant chemotherapy and timing of tamoxifen in postmenopausal patients with endocrine-responsive, node-positive breast cancer: a phase 3, open-label, randomised controlled trial. Lancet 2009;374:2055-63
103. Falandry C, Canney PA, Freyer G, Dirix LY. Role of combination therapy with aromatase and cyclooxygenase-2 inhibitors in patients with metastatic breast cancer. Ann Oncol 2009;20:615-20
104. Olsen SR. Taxanes and COX-2 inhibitors: from molecular pathways to clinical practice. Biomed Pharmacother 2005;59(Suppl 2):S306-310
105. Dirix L, Ignacio J, Nag S, et al. Treatment of advanced hormone-sensitive breast cancer in postmenopausal women with exemestane alone or in combination with celecoxib. J Clin Oncol 2008;26:1253-9