Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Published Results
Related Publications
Trial Contact Information
Registry Information

Alternate Title

Exemestane Compared With Tamoxifen in Treating Postmenopausal Women With Breast Cancer

Basic Trial Information

Objectives

1. Compare the efficacy and tolerability of adjuvant exemestane versus adjuvant tamoxifen in postmenopausal women with early breast cancer.
2. Compare the relapse-free survival and overall survival of patients treated with these drugs.
3. Compare the incidence of contralateral breast cancer in patients treated with these drugs.
4. Compare the safety and long-term tolerability of these drugs in these patients.
5. Compare the quality of life of patients treated with these drugs.

Entry Criteria

Disease Characteristics:

• Histologically or cytologically confirmed early adenocarcinoma of the breast
  • Completely excised by surgery with curative intent (R0)
    • Any N

      OR

    • Any primary tumor greater than 3 cm

      OR

    • Any primary tumor grade III and greater than 1 cm
  • M0

• No positive supraclavicular nodes

• Hormone receptor status:
  • Estrogen and/or progesterone receptor positive

Prior/Concurrent Therapy:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior neoadjuvant chemotherapy
• No more than 10 weeks since completion of prior adjuvant chemotherapy

Endocrine therapy:

• No prior adjuvant hormonal therapy for breast cancer
• No prior neoadjuvant hormonal therapy (prior to surgery) for duration of more than 4 weeks
• At least 4 weeks since prior hormone replacement therapy

Radiotherapy:

• Not specified

Surgery:

• See Disease Characteristics
• No more than 10 weeks since completion of curative surgery

Other:

• No other concurrent investigational agents or participation in another clinical study (except adjuvant cytotoxic chemotherapy studies)
• Concurrent bisphosphonates allowed

Patient Characteristics:

Age:

• Any age
• See Menopausal status

Sex:

• Female

Menopausal status:

• Postmenopausal
  • Any age with bilateral oophorectomy or amenorrhea for at least 5 years

    OR

  • Age 50 or over:
    • Natural amenorrhea for at least 1 year

      OR

    • Chemotherapy-induced amenorrhea for at least 2 years

      OR

    • Radiation-induced amenorrhea (at least 3 months since prior radiotherapy)

      OR

  • Under age 50:
    • If amenorrheic for less than 5 years (any cause) or prior hysterectomy without bilateral surgical oophorectomy, follicle-stimulating hormone must be assayed to confirm postmenopausal status

Performance status:

• ECOG 0-2

Life expectancy:

• Not specified

Hematopoietic:

• Platelet count greater than 100,000/mm3
• WBC greater than 3,000/mm3

Hepatic:

• SGOT or SGPT less than 2.5 times upper limit of normal (ULN)

Renal:

• Creatinine less than 1.5 times ULN

Cardiovascular:

• No uncontrolled cardiac disease
• No unstable angina
• No congestive heart failure or arrhythmia requiring medical therapy
• No myocardial infarction within the past 3 months

Other:

• No severe osteoporosis
• No other malignancies within the past 5 years except adequately treated carcinoma in situ of the cervix or basal cell skin cancer
• No other serious concurrent disease that would preclude study
• No psychiatric disorders that would preclude study

Expected Enrollment

Approximately 4,400 patients (2,200 per treatment arm) will be accrued for this study.

Outcomes

Relapse-free survival

Overall survival
Incidence of second breast cancer in contralateral breast
Safety and long term tolerability
Quality of life

Outline

This is a randomized, open-label, multicenter study. Patients are stratified according to estrogen receptor (ER)/progesterone receptor (PgR) status (ER positive vs ER negative/PgR positive vs ER positive/PgR unknown), prior chemotherapy (none vs taxane-based vs anthracycline-based vs other), and nodal status (negative vs 1-3 nodes positive vs 4 or more nodes positive). Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients receive oral tamoxifen once daily

• Arm II: Patients receive oral exemestane once daily.

Treatment in both arms continues for a minimum of 5 years in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline and at months 3 and 12 during study.

Patients are followed at least annually.

van de Velde CJ, Rea D, Seynaeve C, et al.: Adjuvant tamoxifen and exemestane in early breast cancer (TEAM): a randomised phase 3 trial. Lancet 377 (9762): 321-31, 2011.[PUBMED Abstract]

Kieback DG, Harbeck N, Bauer W, et al.: Endometrial effects of exemestane compared to tamoxifen within the Tamoxifen Exemestane Adjuvant Multicenter (TEAM) trial: results of a prospective gynecological ultrasound substudy. Gynecol Oncol 119 (3): 500-5, 2010.[PUBMED Abstract]

Hadji P, Ziller M, Kieback DG, et al.: Effects of exemestane and tamoxifen on bone health within the Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial: results of a German, 12-month, prospective, randomised substudy. Ann Oncol 20 (7): 1203-9, 2009.[PUBMED Abstract]

Hadji P, Ziller M, Kieback DG, et al.: The effect of exemestane or tamoxifen on markers of bone turnover: results of a German sub-study of the Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial. Breast 18 (3): 159-64, 2009.[PUBMED Abstract]

Hadji P, Asmar L, van Nes JG, et al.: The effect of exemestane and tamoxifen on bone health within the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial: a meta-analysis of the US, German, Netherlands, and Belgium sub-studies. J Cancer Res Clin Oncol 137 (6): 1015-25, 2011.[PUBMED Abstract]

Trial Contact Information

Trial Lead Organizations

Cancer Research UK Clinical Trials Unit - Birmingham

Daniel Rea, MD, Protocol chair		Ph: 44-121-507-5241

Registry Information
Official Title		An Open Label, Randomized Multicenter Comparative Trial Of 5 Years Adjuvant Exemestane Treatment Versus 5 Years Adjuvant Tamoxifen Treatment In Postmenopausal Women With Early Breast Cancer
Trial Start Date		2001-12-05
Registered in ClinicalTrials.gov		NCT00032136
Date Submitted to PDQ		2002-01-23
Information Last Verified		2007-03-27

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