By Exemestane, a Novel Irreversible Aromatase Inhibitor, in Postmenopausal Breast Cancer Patients1
Vol. 4, 2089-2093, September 1998 Clinical Cancer Research 2089 In Vivo Inhibition of Aromatization by Exemestane, a Novel Irreversible Aromatase Inhibitor, in Postmenopausal Breast Cancer Patients1 Jfirgen Geisler, Nick King, Gun Anker, ation aromatase inhibitor AG3 has been used for breast cancer Giorgio Ornati, Enrico Di Salle, treatment for more than two decades (1). Because of substantial side effects associated with AG treatment, several new aro- Per Eystein L#{248}nning,2 and Mitch Dowsett matase inhibitors have been introduced in clinical trials. Department of Oncology, Haukeland University Hospital, N-502l Aromatase inhibitors can be divided into two major classes Bergen, Norway [J. G., G. A., P. E. L.]; Academic Department of Biochemistry, Royal Marsden Hospital, London, SW3 6JJ, United of compounds, steroidal and nonsteroidal drugs. Nonsteroidal Kingdom [N. K., M. D.]; and Department of Experimental aromatase inhibitors include AG and the imidazole/triazole Endocrinology, Pharmacia and Upjohn, 20014 Nerviano, Italy [G. 0., compounds. With the exception of testololactone, a testosterone E. D. S.] derivative (2), steroidal aromatase inhibitors are all derivatives of A, the natural substrate for the aromatase enzyme (3). The second generation steroidal aromatase inhibitor, 4- ABSTRACT hydroxyandrostenedione (4-OHA, formestane), was found to The effect of exemestane (6-methylenandrosta-1,4- inhibit peripheral aromatization by -85% when administered diene-3,17-dione) 25 mg p.o. once daily on in vivo aromati- by the i.m. route at a dosage of 250 mg every 2 weeks as zation was studied in 10 postmenopausal women with ad- recommended (4) but only by 50-70% (5) when administered vanced breast cancer.
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