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Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

Examestane in advanced or recurrent endometrial carcinoma: a prospective phase II study by the Nordic Society of Gynecologic Oncology (NSGO)

Authors: Kristina Lindemann, Susanne Malander, Rene D Christensen, Mansoor R Mirza, Gunnar B Kristensen, Elisabeth Aavall-Lundqvist, Ignace Vergote, Per Rosenberg, Karin Boman, Britta Nordstrøm

Published in: BMC Cancer | Issue 1/2014

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Abstract

Background

We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma.

Methods

We performed an open-label one-arm, two-stage, phase II study of 25 mg of oral exemestane in 51 patients with advanced (FIGO stage III-IV) or relapsed endometrioid endometrial cancer. Patients were stratified into subsets of estrogen receptor (ER) positive and ER negative patients.

Results

Recruitment to the ER negative group was stopped prematurely after 12 patients due to slow accrual. In the ER positive patients, we observed an overall response rate of 10%, and a lack of progression after 6 months in 35% of the patients. No responses were registered in the ER negative patients, and all had progressive disease within 6 months. For the total group of patients, the median progression free survival (PFS) was 3.1 months (95% CI: 2.0-4.1). In the ER positive patients the median PFS was 3.8 months (95% CI: 0.7-6.9) and in the ER negative patients it was 2.6 months (95% CI: 2.1-3-1). In the ER positive patients the median overall survival (OS) time was 13.3 months (95% CI: 7.7-18.9), in the ER negative patients the corresponding numbers were 6.1 months (95% CI: 4.1-8.2). Treatment with exemestane was well tolerated.

Conclusion

Treatment of estrogen positive advanced or recurrent endometrial cancer with exemestane, an aromatase inhibitor, resulted in a response rate of 10% and lack of progression after 6 months in 35% of the patients.

Trial registration

Trial identification number (Clinical Trials.gov): NCT01965080.
Nordic Society of Gynecological Oncology: NSGO–EC–0302.
EudraCT number: 2004-001103-35.
Appendix
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Literature
1.
go back to reference Parkin DM, Ferlay J, Curado MP, Bray F, Edwards B, Shin HR, Forman D: Fifty years of cancer incidence: CI5 I-IX. Int J Cancer J Int Du Cancer. 2010, 127 (12): 2918-2927. 10.1002/ijc.25517.CrossRef Parkin DM, Ferlay J, Curado MP, Bray F, Edwards B, Shin HR, Forman D: Fifty years of cancer incidence: CI5 I-IX. Int J Cancer J Int Du Cancer. 2010, 127 (12): 2918-2927. 10.1002/ijc.25517.CrossRef
2.
go back to reference Lindemann K, Eskild A, Vatten LJ, Bray F: Endometrial cancer incidence trends in Norway during 1953-2007 and predictions for 2008-2027. Int J Cancer J Int Du Cancer. 2010, 127 (11): 2661-2668. 10.1002/ijc.25267.CrossRef Lindemann K, Eskild A, Vatten LJ, Bray F: Endometrial cancer incidence trends in Norway during 1953-2007 and predictions for 2008-2027. Int J Cancer J Int Du Cancer. 2010, 127 (11): 2661-2668. 10.1002/ijc.25267.CrossRef
3.
go back to reference Jongen V, Briet J, de Jong R, ten Hoor K, Boezen M, van der Zee A, Nijman H, Hollema H: Expression of estrogen receptor-alpha and -beta and progesterone receptor-A and-B in a large cohort of patients with endometrioid endometrial cancer. Gynecol Oncol. 2009, 112 (3): 537-542. 10.1016/j.ygyno.2008.10.032.CrossRefPubMed Jongen V, Briet J, de Jong R, ten Hoor K, Boezen M, van der Zee A, Nijman H, Hollema H: Expression of estrogen receptor-alpha and -beta and progesterone receptor-A and-B in a large cohort of patients with endometrioid endometrial cancer. Gynecol Oncol. 2009, 112 (3): 537-542. 10.1016/j.ygyno.2008.10.032.CrossRefPubMed
4.
go back to reference Decruze SB, Green JA: Hormone therapy in advanced and recurrent endometrial cancer: a systematic review. Int J Gynecol Cancer. 2007, 17 (5): 964-978. 10.1111/j.1525-1438.2007.00897.x.CrossRefPubMed Decruze SB, Green JA: Hormone therapy in advanced and recurrent endometrial cancer: a systematic review. Int J Gynecol Cancer. 2007, 17 (5): 964-978. 10.1111/j.1525-1438.2007.00897.x.CrossRefPubMed
5.
go back to reference Singh M, Zaino RJ, Filiaci VJ, Leslie KK: Relationship of estrogen and progesterone receptors to clinical outcome in metastatic endometrial carcinoma: a gynecologic oncology group study. Gynecol Oncol. 2007, 106 (2): 325-333. 10.1016/j.ygyno.2007.03.042.CrossRefPubMed Singh M, Zaino RJ, Filiaci VJ, Leslie KK: Relationship of estrogen and progesterone receptors to clinical outcome in metastatic endometrial carcinoma: a gynecologic oncology group study. Gynecol Oncol. 2007, 106 (2): 325-333. 10.1016/j.ygyno.2007.03.042.CrossRefPubMed
6.
go back to reference Kauppila A: Progestin therapy of endometrial, breast and ovarian carcinoma: a review of clinical observations. Acta obstetricia et gynecologica Scandinavica. 1984, 63 (5): 441-450. 10.3109/00016348409156700.CrossRefPubMed Kauppila A: Progestin therapy of endometrial, breast and ovarian carcinoma: a review of clinical observations. Acta obstetricia et gynecologica Scandinavica. 1984, 63 (5): 441-450. 10.3109/00016348409156700.CrossRefPubMed
7.
go back to reference Sehouli J, Koensgen D, Oskay-Ozcelik G, Mustea A: New aspects of adjuvant therapy in endometrial cancer: current standards and future directions. Critical Rev Oncol/Hematol. 2008, 67 (3): 204-212. 10.1016/j.critrevonc.2008.02.011.CrossRef Sehouli J, Koensgen D, Oskay-Ozcelik G, Mustea A: New aspects of adjuvant therapy in endometrial cancer: current standards and future directions. Critical Rev Oncol/Hematol. 2008, 67 (3): 204-212. 10.1016/j.critrevonc.2008.02.011.CrossRef
8.
go back to reference Kokka F, Brockbank E, Oram D, Gallagher C, Bryant A: Hormonal therapy in advanced or recurrent endometrial cancer. Cochrane Database Syst Rev. 2010, 12: CD007926-PubMed Kokka F, Brockbank E, Oram D, Gallagher C, Bryant A: Hormonal therapy in advanced or recurrent endometrial cancer. Cochrane Database Syst Rev. 2010, 12: CD007926-PubMed
9.
go back to reference Judd HL, Shamonki IM, Frumar AM, Lagasse LD: Origin of serum estradiol in postmenopausal women. Obstetrics Gynecol. 1982, 59 (6): 680-686. Judd HL, Shamonki IM, Frumar AM, Lagasse LD: Origin of serum estradiol in postmenopausal women. Obstetrics Gynecol. 1982, 59 (6): 680-686.
10.
go back to reference Ma BB, Oza A, Eisenhauer E, Stanimir G, Carey M, Chapman W, Latta E, Sidhu K, Powers J, Walsh W, et al: The activity of letrozole in patients with advanced or recurrent endometrial cancer and correlation with biological markers–a study of the national cancer institute of canada clinical trials group. Int J Gynecol Cancer. 2004, 14 (4): 650-658. 10.1111/j.1048-891X.2004.14419.x.CrossRefPubMed Ma BB, Oza A, Eisenhauer E, Stanimir G, Carey M, Chapman W, Latta E, Sidhu K, Powers J, Walsh W, et al: The activity of letrozole in patients with advanced or recurrent endometrial cancer and correlation with biological markers–a study of the national cancer institute of canada clinical trials group. Int J Gynecol Cancer. 2004, 14 (4): 650-658. 10.1111/j.1048-891X.2004.14419.x.CrossRefPubMed
11.
go back to reference Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB: A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a gynecologic oncology group study. Gynecol Oncol. 2000, 78 (2): 212-216. 10.1006/gyno.2000.5865.CrossRefPubMed Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB: A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a gynecologic oncology group study. Gynecol Oncol. 2000, 78 (2): 212-216. 10.1006/gyno.2000.5865.CrossRefPubMed
12.
go back to reference Lintermans A, Neven P, Paridaens R: Drug safety evaluation of exemestane. Expert Opin Drug Safety. 2011, 10 (3): 473-487. 10.1517/14740338.2011.567264.CrossRef Lintermans A, Neven P, Paridaens R: Drug safety evaluation of exemestane. Expert Opin Drug Safety. 2011, 10 (3): 473-487. 10.1517/14740338.2011.567264.CrossRef
13.
go back to reference Nordstrom BM, De Pont Christensen R, Oksefjell H, Kristensen G: Exemestane in advanced and recurrent endometrial carcinoma: a phase II study by NSGO. ASCO Ann Meeting Proc. 2006, 24: 266s- Nordstrom BM, De Pont Christensen R, Oksefjell H, Kristensen G: Exemestane in advanced and recurrent endometrial carcinoma: a phase II study by NSGO. ASCO Ann Meeting Proc. 2006, 24: 266s-
14.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, et al: New guidelines to evaluate the response to treatment in solid tumors: European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92 (3): 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, et al: New guidelines to evaluate the response to treatment in solid tumors: European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92 (3): 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed
16.
go back to reference Slomovitz BSP, Levenback C, Brown J, Wolf J, Schmeler K, Johnston T, Mura D, Stone RL, Lu K, Coleman RL: Everolimus and letrozole in women with previously treated recurrent endometrial cancer: a multiinstitutional phase II clinical trial. Int J Gynecol Cancer. 2012, 22 (suppl. 3): 8- Slomovitz BSP, Levenback C, Brown J, Wolf J, Schmeler K, Johnston T, Mura D, Stone RL, Lu K, Coleman RL: Everolimus and letrozole in women with previously treated recurrent endometrial cancer: a multiinstitutional phase II clinical trial. Int J Gynecol Cancer. 2012, 22 (suppl. 3): 8-
Metadata
Title
Examestane in advanced or recurrent endometrial carcinoma: a prospective phase II study by the Nordic Society of Gynecologic Oncology (NSGO)
Authors
Kristina Lindemann
Susanne Malander
Rene D Christensen
Mansoor R Mirza
Gunnar B Kristensen
Elisabeth Aavall-Lundqvist
Ignace Vergote
Per Rosenberg
Karin Boman
Britta Nordstrøm
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-68

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