AROMASIN
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Approximately 3 million women in the US are living with breast cancer[1]
- In 2007, 240,510 new cases of breast cancer will be diagnosed among women in the US: 178,480 invasive breast cancers and and 62,030 cases in situ breast cancer,[1] and 40,460 to die of breast cancer.[1] The lifetime probability of developing invasive breast cancer by age 39 years is 0.48 (1 in 207), age 40 to 59 years is 4.18 (1 in 24), age 60 to 79 years is 7.49 (1 in 13).[2] 1 in 7 women will develop breast cancer in her lifetime[2]
- Hormone-receptor status in women 50 to 80 years old with invasive breast cancer. Data from 1998[3]:
- Estrogen receptor positive: 75%-85%
- Progesterone receptor positive: 66%-68%
- Incidence rates (per 100,000) by race[2]:
- All races: 135.2
- White: 141.7
- African American: 119.9
- Hispanic, Latino: 89.6
- Mortality rates (per 100,000) by race[2]:
- All races: 27.0
- White: 26.4
- African American: 35.4
- Hispanic, Latino: 17.3
- Among cancer survivors[4]:
- 14.3% unable to work due to health problems
- 22.5% limited in amount/kind of work due to health problems
- 21.0 average days lost from work in past 12 months
- 3.9% need help with Activity of Daily Living (ADL), such as showering, dressing, getting out of bed, using toilet, and eating
- 10.5% need help with Instrumental Activities of Daily Living (IADL), such as preparing meals, managing money, shopping, performing housework
- Risk factors for breast cancer include[2,5,6]:
- Increasing age, female gender, high and low socioeconomic status, white race
- Family history of breast cancer, inherited genetic mutations
- History of benign breast disease or invasive breast cancer, increased breast density
- Endogenous hormone factors: younger age at menarche, older age at first live birth, older age at menopause, fewer pregnancies
- Exogenous hormone factors: current use of oral contraceptive or hormone replacement therapy
- Lifestyle factors: high body mass index after menopause, alcohol consumption
- Environmental factors: exposure to ionizing radiation after age 10
- Average annual health care costs for postmenopausal women (age 50-64 years) treated for breast cancer: 1998-2000[7]:
- Direct cost:
- Indirect cost:
- Mean cancer-related monthly costs paid by Medicare for elderly women diagnosed with early breast cancer (US $, 1998)[8]:
- Initial phase: $1462
- Continuing care: $112
- Terminal phase: $2561
- Mean monthly out-of-pocket costs for women with breast cancer who are covered by private, Medicare, or Medicaid insurance (US $/year; study period: 1999-2002)[9]:
- Age: 45 to 64 years
- Total: $1402
- Direct medical: $573
- Direct nonmedical: $86
- Indirect: $743
- Age: ≥ 65 years
- Total: $627
- Direct medical: $339
- Direct nonmedical: $131
- Indirect: $157
| Breast Cancer | Random Sample | |
|---|---|---|
|
| $13,925 | $2,951 |
| $8,236 | $2,292 |
AROMASIN® (exemestane tablets)
AROMASIN is indicated for adjuvant treatment of postmenopausal women with estrogen receptor-positive early breast cancer who have received 2 to 3 years of tamoxifen and are switched to AROMASIN for completion of a total of 5 consecutive years of adjuvant hormonal therapy.
AROMASIN is indicated for the treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy.
Important Safety Information
AROMASIN (exemestane tablets) should not be used in women who are premenopausal, are nursing or pregnant, have a known hypersensitivity to the drug, or are taking estrogen-containing agents.
Dose modification is recommended for patients who are receiving certain medications, including strong CYP 3A4 inducers such as rifampicin and phenytoin.
In patients with early breast cancer, elevations in bilirubin, alkaline phosphatase, and creatinine were more common in those receiving exemestane than either tamoxifen or placebo.
Reductions in bone mineral density over time are seen with AROMASIN use.
Incidence of adverse events (AEs; %) occurring in ≥10% of patients in any treatment group (AROMASIN vs tamoxifen) in the Intergroup Exemestane Study (IES): hot flushes (21.2 vs 19.9), fatigue (16.1 vs 14.7), arthralgia (14.6 vs 8.6), headache (13.1 vs 10.8), insomnia (12.4 vs 8.9), and increased sweating (11.8 vs 10.4).
In IES, discontinuation rate due to AEs was similar between AROMASIN and tamoxifen (6.3% vs 5.1%). Incidence of cardiac ischemic events (myocardial infarction, angina, and myocardial ischemia): AROMASIN 1.6%, tamoxifen 0.6%. Incidence of cardiac failure: AROMASIN 0.4%, tamoxifen 0.3%.
Most common adverse events reported for advanced breast cancer were mild to moderate and included hot flashes (13%), nausea (9%), fatigue (8%), increased sweating (4%), and increased appetite (3%).
References
- Facts about breast cancer in the United States: Year 2007. National Breast Cancer Coalition Web Site. http://www.natlbcc.org/bin/index.asp?strid=427&depid= . Accessed March 29, 2007.
- Jemal A, Murray T, Ward E, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005;55:10-30.
- Li CI, Daling JR, Malone KE. Incidence of invasive breast cancer by hormone receptor status form 1992 to 1998. J Clin Oncol. 2003; 21:28-34
- Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004;96:1322-1330.
- Veronesi U, Boyle P, Goldhirsch A, Orecchia R, Viale G. Breast cancer. Lancet. 2005;365:1727-1741.
- Clemons M, Goss P. Mechanisms of disease: Estrogen and the risk of breast cancer. N Engl J Med. 2001;344:276-285.
- Sasser AC, Rousculp MD, Birnbaum HG, Oster EF, Lufkin E, Mallet D. Economic burden of osteoporosis, breast cancer and cardiovascular disease among postmenopausal women in an employed population. Women's Health Issues. 2005;15:97-108.
- Warren JL, Brown ML, Fay MP, Schussler N, Potosky AL, Riley GF. Costs of treatment for elderly women with early-stage breast cancer in fee-for-service settings. J Clin Oncol. 2002;20:307-316.
- Arozullah AM, Calhoun EA, Wolf M, et al. The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol. 2004;2:271-278.
