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Exemestane

Phase 3

Breast Neoplasms | Small molecule | Oncology |Pfizer, Inc.|Last Updated: Oct 28, 2015

Target and mechanism

Molecular targetCYP19A1
Target classInhibitor
ModalitySmall molecule

Also known as exemestane (Aromasin®), exemestane (Aromasin)

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials6
Total Enrollment24,753

FDA Designations

No designations recorded

Clinical trial landscape

Exemestane · 7 trials · 2 indications

Phase 3 5Phase 2 2
NCT00143390Aromasin Vs Arimidex Study As Initial Hormonal Therapy In Postmenopausal Women With Advanced/Recurrent Breast CancerBreast Neoplasms
COMPLETED298 Analytics
NCT00279448Exemestane As Treatment In Adjuvant For Post-Menopausal Patients With Non-Metastatic Breast CancerBreast Neoplasms
COMPLETED9,779 Analytics
NCT01237327Multicenter Follow Up Study Of Subjects Who Participated In An Original Protocol Of Exemestane Vs. Megestrol Acetate In Postmenopausal Women With Metastatic Breast CancerMetastatic Breast Cancer
COMPLETED84 Analytics
NCT00036270Randomized Phase III Study Of Exemestane (Aromasin) For 5 Years Versus Tamoxifen for 2.5 to 3 Years Followed By ExemestaneBreast Neoplasms
COMPLETED9,779 Analytics
NCT00038467Randomized Trial Of Exemestane Versus Continued Tamoxifen In Postmenopausal Women With Early Breast CancerBreast Neoplasms
COMPLETED4,740 Analytics
PHASE3COMPLETED
Aromasin Vs Arimidex Study As Initial Hormonal Therapy In Postmenopausal Women With Advanced/Recurrent Breast Cancer
Breast NeoplasmsUnlock trial analytics
PHASE3COMPLETED
Exemestane As Treatment In Adjuvant For Post-Menopausal Patients With Non-Metastatic Breast Cancer
Breast NeoplasmsUnlock trial analytics
PHASE3COMPLETED
Multicenter Follow Up Study Of Subjects Who Participated In An Original Protocol Of Exemestane Vs. Megestrol Acetate In Postmenopausal Women With Metastatic Breast Cancer
Metastatic Breast CancerUnlock trial analytics
PHASE3COMPLETED
Randomized Phase III Study Of Exemestane (Aromasin) For 5 Years Versus Tamoxifen for 2.5 to 3 Years Followed By Exemestane
Breast NeoplasmsUnlock trial analytics
PHASE3COMPLETED
Randomized Trial Of Exemestane Versus Continued Tamoxifen In Postmenopausal Women With Early Breast Cancer
Breast NeoplasmsUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to Progression (TTP) - Expert Evaluation Committee Assessment
Up to 2008 days of the treatment

Time in months from randomization to first documentation of objective tumor progression or death due to breast cancer, whichever comes first. Tumor progression was determined by the expert evaluation committee using RECIST version 1.0 as an at least a 20% increase in the sum of the longest diameters (SLD) of the target lesions compared to the smallest SLD since the study treatment started. For participants with bone metastasis only, at least 25% increase in the measurable lesion according to General Rules for Clinical and Pathological Study of Breast Cancer (The 14th edition).

To compare recurrence free survival between two treatment groups.
2.75 years and 5 years
Overall Survival
Every 12 weeks up to 6 years

Overall survival in months measured from date of starting treatment in core study to date of death for any reason.

Disease Free Survival (DFS): Number of Events (Disease Relapse or Death) From Baseline up to 2.75 Years
Baseline (Month 0) up to 2.75 years

Number of events (disease relapse or death) to time of observation for DFS. DFS defined as time from randomization to earliest documentation of disease relapse or death from any cause in postmenopausal, receptor positive, node negative or node positive breast cancer patients for adjuvant treatment with exemestane compared with adjuvant tamoxifen therapy at 2.75 years. Disease relapse: primary tumor recurrence (locoregional or distant) and ipsilateral or contralateral breast cancer (CBC). Intercurrent death: death without disease relapse.

Disease Free Survival (DFS): Number of Events (Disease Relapse or Death) From Baseline up to 5 Years
Baseline (Month 0) up to 5 years

Number of events (disease relapse or death) to time of observation for DFS. DFS defined as time from randomization to earliest documentation of disease relapse or death from any cause in postmenopausal, receptor positive, node negative or node positive breast cancer patients for adjuvant treatment with exemestane compared with adjuvant tamoxifen therapy at 5 years. Disease relapse: primary tumor recurrence (locoregional or distant) and ipsilateral or contralateral breast cancer (CBC). Intercurrent death: death without disease relapse.

Disease-Free Survival (DFS) at Month 36 Post-Randomization: Main Study
Baseline up to Month 36

DFS defined as time from randomization to earliest documentation of breast cancer relapse or death from any cause. DFS at Month 36 post-randomization was defined as probability of participants alive and disease-free at 36 months after the randomization. Participants withdrawn from the study for any reason in the absence of relapse were censored at the date they were last seen. Relapse was categorized as follows: loco-regional: ipsilateral breast or axillary nodal relapse; distant: distant relapse, including supraclavicular nodes; second primary breast cancer: contralateral breast cancer, excluding ductal carcinoma in situ.

Number of Subjects With Clinical Benefit
Baseline, Week 8, 16, 24, and every 12 weeks beyond 24 up to Week 108 and every 24 weeks thereafter until 9 months following last subject last visit (LSLV)

Clinical benefit was based on objective tumor assessments made according to Response Evaluation Criteria (RECIST) system of unidimensional evaluation. Includes subjects with complete response (CR), partial response (PR), and long term disease stabilization (SD) for at least 24 weeks.

To evaluate clinical and pathologic response rates following primary hormonal therapy by exemestane (Aromasin®)

Secondary Endpoints

Time to Progression (TTP) - Investigators Assessment
Up to 2008 days of the treatment
Number of Participants With Objective Response - Investigators Assessment
Up to 2008 days of the treatment
Number of Participants With Clinical Benefit - Investigator Assessment
Up to 2008 days of the treatment
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
1EXPERIMENTAL -
2EXPERIMENTAL -
AEXPERIMENTAL -
BACTIVE_COMPARATOR -
exemestaneEXPERIMENTAL -
tamoxifen + exemestaneEXPERIMENTAL -
1.ACTIVE_COMPARATOR -
2.EXPERIMENTAL -

Interventions

NameTypeDescription
exemestaneDRUGtake orally one tablet per day of exemestane 25 mg and one tablet per day of anastrozole placebo daily after meal
anastrozoleDRUGtake orally one tablet of anastrozole 1 mg and one tablet of exemestane placebo daily after meal
tamoxifenDRUGTwo tablets of tamoxifen 10 mg per day during 2.5 to 3 years followed by one tablet of exemestane 25 mg per day during 2 to 2.5 years for a total duration of 5 years of treatment
Megestrol acetateDRUGMegestrol Acetate 160 mg oral tablets Qd
exemestane (Aromasin)DRUGexemestane (Aromasin) 25 mg oral tablets Qd
tamoxifen + exemestaneDRUGtamoxifen, 20 mg, orally, daily, 2-3 years; followed by exemestane, orally, 25 mg, for a total of 5 years of therapy
Celecoxib + ExemestaneDRUGExemestane + celecoxib treatment arm, she will be instructed to take also two x 200 mg celecoxib capsules twice a day, every day, with food.
exemestane (Aromasin®)DRUG -
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Eligibility Criteria

Age Range20 Years to N/A
SexFEMALE
Healthy VolunteersNo
Study Sites47

Inclusion Criteria: * Have histologically or cytologically confirmed breast cancer at original diagnosis. At study entry, the patient must have metastatic progressive or locally recurrent inoperable breast cancer. Exclusion Criteria: * Having received any hormonal therapy (e.g., Tamoxifen, LHRH-a...

Countries:JapanFranceChinaUnited StatesArgentinaAustraliaBelgiumBosnia and HerzegovinaBulgariaCroatiaCzechiaDenmarkEgyptEstoniaGermanyGreeceHong KongHungaryIrelandIsraelItalyLuxembourgMaltaNetherlandsNew ZealandNorwayPeruPolandPortugalRomaniaRussiaSerbiaSlovakiaSloveniaSouth AfricaSpainSwedenSwitzerlandUnited KingdomBrazilCanadaColombiaIndiaMexicoPhilippines
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