Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display

3922 - Predictors of effectiveness of the use of steroidal aromatase inhibitors after progression on non-steroidal aromatase inhibitors in advanced breast cancer patients


10 Oct 2016


Poster display


Maria Madalena Ulrich de Menezes Pereira dos Santos


Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365


M.M. Ulrich de Menezes Pereira dos Santos, C. Cardoso, M. Sousa, S. Esteves, M. Brito, A. Moreira

Author affiliations

  • Oncology, IPO LFG, 1250-255 Lisboa - Lisboa/PT


Abstract 3922


Clinical evidence suggests that steroid aromatase inhibitors (SAI) lack cross resistance with non-steroid aromatase inhibitors (nSAI). Therefore, the use of SAI in advanced breast cancer (ABC) patients (pts) after disease progression on nSAI has been considered a reasonable option in several centers. Our aim is to confirm the effectiveness of using this strategy in ABC and identify predictors of response.


Retrospective analysis of a cohort of consecutive ABC female postmenopausal hormone receptor patients treated in a single cancer center with SAI (exemestane) after progression with nSAI (letrozol or anastrozole), between 2009 and 2013. Effectiveness outcomes were time to progression (TTP) and clinical benefit (CB), defined as complete response or partial response or stable disease for more than 6 months. We used logistic and Cox regression models.


160 ABC pts were identified, with a median age of 60 (range 32-87). In 74% pts estrogen receptor was high (≥75%) and in 16% HER2 was overexpressed. Visceral disease was present in 25% pts and 67% had been previously treated with adjuvant endocrine therapy. In ABC, 57% were initially treated with nSAI. The average number of therapeutic lines until exemestane was 2.3 (1-8) and 33% were treated with exemestane immediately after progression under nSAI. The exemestane CB rate was 64%. In univariable analysis, the factors associated with CB were visceral disease (p = 0.047), previous CB to nSAI (p = 0.047) and number of treatment lines between nSAI and exemestane (p = 0.011). In multivariable analysis, visceral disease and CB to nSAI were the only independent factors significantly associated with CB to exemestane (OR 0.38 and 2.15, respectively). Median TTP was 7.8m (95%CI 6.8-9.2). In multivariable analysis, visceral disease and the number of treatments between AI were the only independent factors significantly associated with TTP (HR 1.35 and 1.56, respectively).


The use of exemestane after progression on nSAI seems to be a valid option, especially in ABC patients with non-visceral disease, few treatment lines between nSAI and SAI and with previous CB to nSAI.

Clinical trial identification

Legal entity responsible for the study

IPO Lisboa


IPO Lisboa


All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings