Adjuvant tamoxifen and exemestane in early breast cancer (TEAM): a randomised phase 3 trial

Velde, Cornelis J.H. van de; Rea, Daniel; Seynaeve, Caroline; Putter, Hein; Hasenburg, Annette; Vannetzel, Jean-Michel; Paridaens, Robert; Markopoulos, Christos; Hozumi, Yasuo; Hille, E.T.M.; Kieback, Dirk G.; Asmar, Lina; Smeets, Jan; Nortier, J.W.R.; Hadji, Peyman; Bartlett, John M.S.; Jones, Stephen E.

doi:10.1016/s0140-6736(10)62312-4

Cited by 349 publications

(227 citation statements)

References 28 publications

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“…Hypertension was increased in the latter group, which may explain why the overall incidence of cardiovascular events was similar in the two groups. Similar findings were reported in the TEAM trial (van de Velde et al 2011).…”

Section: Cardiovascular Adverse Eventssupporting

confidence: 90%

“…The trial had to be modified because the results of the IES were published while the TEAM trial was still ongoing, indicating that 5 years adjuvant tamoxifen might be considered as a suboptimal adjuvant treatment. The modified TEAM design compared long-term effects of exemestane monotherapy for 5 years with the tamoxifen/ exemestane 'switch' strategy in postmenopausal women with HR-positive breast cancer (van de Velde et al 2011).…”

Section: Adjuvant Settingmentioning

confidence: 99%

“…Both randomized adjuvant IES and TEAM trials reported high numbers of hot flashes among postmenopausal breast cancer patients treated with exemestane (Coombes et al 2004, van de Velde et al 2011. In a TEAM substudy, hot flashes complaints were compared between the first year of either adjuvant exemestane or tamoxifen treatment ).…”

Section: Hot Flashesmentioning

confidence: 99%

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Aromatase inhibitors in the breast cancer clinic: focus on exemestane

Asten¹,

Neven²,

Lintermans³

et al. 2014

Endocrine-Related Cancer

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Breast cancer is the most prevalent type of cancer in women and responsible for significant female cancer-related mortality worldwide. In the Western world, over 80% of breast cancers are hormone-receptor positive for which endocrine therapy is administered. The main anti-estrogen treatments in use consist of selective estrogen-receptor modulators, such as tamoxifen, and third-generation aromatase inhibitors (AIs), such as exemestane, letrozole, and anastrozole. In this review, the focus will lie on exemestane, its clinical use, and its side-effect profile. Exemestane is the only third-generation steroidal AI. Its efficacy as a first-line treatment in metastatic breast cancer has been demonstrated. Therefore, exemestane could be considered a valid first-line therapeutic option, but it also can be used in second-line or further situations. Exemestane is mostly used as part of sequential adjuvant treatment following tamoxifen, but in this setting it is also active in monotherapy. Furthermore, this AI has been studied in the neoadjuvant setting as presurgical treatment, and even as chemoprevention in high-risk healthy postmenopausal women. It may reverse side effects of tamoxifen, such as endometrial changes and thromboembolic disease but may also cause some inconvenient side effects itself. Additionally, there is a lack of total crossresistance between exemestane and nonsteroidal AIs as far as their anti-tumoral efficacy is concerned; moreover the two classes of AIs display a nontotal overlapping toxicity profile. Taking together, exemestane can be considered as a useful treatment option at all stages of breast cancer.

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Section: Cardiovascular Adverse Eventssupporting

confidence: 90%

Section: Adjuvant Settingmentioning

confidence: 99%

See 1 more Smart Citation

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

Asten¹,

Neven²,

Lintermans³

et al. 2014

Endocrine-Related Cancer

Self Cite

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“…The study design and population of the trial have previously been described in detail. 11 The current study is a side study of the TEAM trial, which is also known as the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle (TEAM-L) side study. This side study prospectively investigated lifestyle habits in a subset of patients.…”

Section: Methodsmentioning

confidence: 99%

Physical activity and survival of postmenopausal, hormone receptor–positive breast cancer patients: Results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study

Glas

Fontein

Bastiaannet

et al. 2014

Cancer

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BACKGROUND: Physical activity has been related to improved breast cancer outcomes. Especially in the older breast cancer population, physical activity may be important because old age is associated with comorbidities and decreased physical function. The purpose of this study was to investigate the relation between physical activity and overall survival, breast cancer-specific survival, and recurrence in several age groups of postmenopausal breast cancer patients. METHODS: The Tamoxifen Exemestane Adjuvant Multinational Lifestyle study was a side study of the Tamoxifen Exemestane Adjuvant Multinational trial and prospectively investigated lifestyle habits of postmenopausal, hormone receptor-positive breast cancer patients. The relations between prediagnosis and postdiagnosis physical activity and overall survival, breast cancer-specific survival, and recurrence-free survival were assessed with Cox regression and competing risk regression models. RESULTS: Among 521 patients, high levels of physical activity before and after the diagnosis were associated with better overall survival (the multivariate hazard ratios were 0.50 [95% confidence interval 5 0.26-0.98] and 0.57 (95% confidence interval 5 0.26-1.40] for patients who were very active before and after the diagnosis, respectively, in comparison with inactive patients). This was most evident in patients who were 65 years old or older. Physical activity was not significantly associated with breast cancer-specific survival or the relapse-free period. CONCLUSIONS: Overall survival was better for patients who were active before and after the diagnosis. In contrast with previous studies, breast cancer survival and the risk of recurrence were not significantly associated with physical activity. These findings confirmed the need for more studies investigating the use of physical activity to supplement breast cancer treatment in older patients. Cancer 2014;120:2847-54.

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“…The 91-month follow-up data for IES031 showed that compared with TAM, exemestane significantly improved disease-free survival, and reduced the risks of local and distant recurrence, while significantly increasing the overall survival rate of ER + patients for unknown reasons. The results of a 2.75-year follow-up by TEAM also showed that, compared with TAM, exemestane significantly reduced the risks of recurrence and distant metastasis (28). A clinical study (29) showed that with regard to the postmenopausal BC patients, when TAM treatment generated resistance, the application of second-line drugs (AIs) would still be effective.…”

Section: A B C D Ementioning

confidence: 99%

Analysis of factors affecting endocrine therapy resistance in breast cancer

Zhang

Chen

2015

Oncology Letters

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Abstract. The present study aimed to identify the factors involved in the resistance to endocrine therapy in breast cancer (BC) patients with a positive estrogen receptor status via the collection of clinical, pathological and immunohistochemical indices. A retrospective survey was performed in patients who experienced the relapse and metastasis of BC between November 2007 and March 2013. A total of 45 patients were enrolled, and the observational duration was 7-84 months. The Kaplan-Meier method was used to create a survival curve, while the log-rank test was used to analyze the survival curve and the Cox regression analysis was used to investigate the associated factors contributing to the resistance to endocrine therapy. Univariate analysis showed that the age of onset, the use of radiotherapy, the endocrine treatment program, and the expression levels of progesterone receptor (PR) and CerbB2 affected the impact of endocrine treatment. The Cox regression analysis indicated that the age of onset, the use of radiotherapy, and the expression levels of PR and CerbB2 affected the disease-free survival time after endocrine therapy. A young age of onset, not receiving radiotherapy, a low expression level of PR and a high expression level of CerbB2 were the risk factors involved in the resistance to endocrine therapy in patients with BC. IntroductionBreast cancer (BC) is a common malignancy that is a serious threat to the health of women. It has been reported that ~1.5 million women are diagnosed with BC annually in the world and that nearly 0.5 million succumb to this disease (1). With accumulating studies on BC, the therapeutic schemes for BC have become much more mature, evolving from the initial local excision to current surgery-based comprehensive treatments, including radiotherapy, chemotherapy, endocrine therapy, biological immune therapy and molecular-targeted therapy.The estrogen receptor (ER) is often found in BC and this cancer is consequently labeled as ER-positive (ERP). Furthermore, as the occurrence and development of BC is so closely associated with the expression of the ER (2), endocrine therapy has been widely used as an effective therapeutic method. In the past few decades, endocrine therapeutic drugs have significantly improved the clinical outcomes of BC patients, as well as their quality of life (3,4). Recently, two multi-center, large-scale, prospective clinical trials further established the positive effect of endocrine therapy in BC treatment (5,6).However, with the extension of endocrine treatment, certain studies found that a few BC patients showed resistance to endocrine therapy. The clinical data indicated that although there were BC-ERP patients who were suitable for endocrine therapy, ~30% of BC-ERP patients exhibited resistance to endocrine drugs in the early stages of treatment (primary resistance), and ~40% BC-ERP of patients showed the effectiveness of endocrine therapy prior to exhibiting gradually reduced sensitivity or resistance with the extension of treatment time (7,8). This E...

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Adjuvant tamoxifen and exemestane in early breast cancer (TEAM): a randomised phase 3 trial

Cited by 349 publications

References 28 publications

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

Physical activity and survival of postmenopausal, hormone receptor–positive breast cancer patients: Results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study

Analysis of factors affecting endocrine therapy resistance in breast cancer

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