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Exemestane Prevents 65% of Invasive Breast Cancers in Postmenopausal Women

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"[Patients] and practitioners now have three options for breast cancer chemoprevention: tamoxifen, raloxifene, and exemestane – agents of proven efficacy that are among the best-studied drugs in the world. Breast cancer is the second most common cause of death from cancer and one of the most feared diagnoses for women in the United States. We have the knowledge and tools to reduce its incidence today. We have run out of excuses. What are we waiting for?"

Dr. Nancy E. Davidson and Thomas W. Kensler, Ph.D., are from the University of Pittsburgh Cancer Institute and UPMC Cancer Centers in Pittsburgh. Their comments appeared in an editorial accompanying the study in the New England Journal of Medicine (10.1056/NEJM1106052).The editorialists disclosed no relevant conflicts of interest.


 

FROM THE ANNUAL MEETING OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY

Dr. Goss said the investigators plan to look for clearer data on how to define which women are high-risk and would benefit from exemestane. They also will be looking for biomarkers that can show how well a woman does while on chemoprevention: something comparable to measures used when patients take anti-hypertensives or cholesterol-lowering drugs.

Another unknown is whether Pfizer, Inc. will seek a chemoprevention indication for exemestane. Aromasin lost patent protection in the United States in Apri, and will lose it in Europe in July, according to company spokesman Christopher Loder. "We cannot comment on our regulatory plans at this time," he said in a hallway interview at the convention center where ASCO is being held.

Loss of exclusivity is likely to mean lower prices for Aromasin, which could make Pfizer less inclined to invest in applications for the indication. Whether insurance companies would pay for chemoprevention use without an indication is also a question – but price might not be a barrier.

Pfizer helped pay for the trial. Dr. Goss and several of his coauthors received honoraria and research funding from Pfizer, as well as other companies. Dr. Davidson and Dr. Kensler disclosed no relevant conflicts of interest.

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