Aromatase Inhibitors: Uses, Dosage, Side Effects, Interactions

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How does hormone therapy work?

The clinical efficacy and safety data were extracted from clinical trials, with detailed information provided in Supplementary Table S2. Pseudo-individual patient data (pseudo-IPD) reconstruction enables a more precise estimation of survival functions by deriving individual-level event times from Kaplan-Meier graphs. This is crucial in calculating more accurate mean survival times, which are fundamental for cost-effectiveness analysis. Pseudo-IPD were extracted using Engauge Digitizer 4.1 from these trials, reconstructed through R version 4.3.2 following the methodology recommended by Guyot and fitted using standard parametric models in IPDfromKM22,23. The standard parametric models including log-normal, gamma, weibull, gompertz, exponential, log-logistic, and generalized gamma functions, were explored to fit the OS and PFS curves24. The optimal fitting distribution was selected based on the lowest value of the AIC and BIC, as well as through visual inspection.

For example, you might be able to have just the tumour removed (a lumpectomy) instead of the whole breast (mastectomy). It is also a possible treatment for breast cancer that has spread to other parts of the body. Two reviewers (AJB, WW) performed data abstraction and quality appraisal, with disagreements resolved through consultation with a third reviewer (CB). The cost of exemestane may be expensive for you based on different factors. These include your treatment plan, your insurance coverage, and the pharmacy you use.

• The healthsrelated utility values applied to the PFS and PD health states were detailed in Table 2.
• The mean number of fulfilled criteria for the CHEERS checklist was 22 out of 28.
• The American Society for Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN) and the U.S.
• The heightened gonadotropin levels also upregulate the aromatase promoter, increasing aromatase production in the setting of increased androgen substrate.
• Patient education provides patients with the necessary tools to guide their AI management.

The primary source of estrogen prior to menopause are the ovaries (not the peripheral conversion of androgens to estrogen by aromatase as in postmenopausal women). Aromatase inhibitors (before going off patent) cost around $2300 per year, according to a study published online June28 in the Journal of Clinical Oncology (by Hershman et al). The alternative therapy in these patients is tamoxifen, which is available generically and costs around $1200 per year. Targeted treatments for HER2-positive breast cancer target the HER2 proteins on or within cancer cells that help the cells to grow. They attach to HER2 proteins and block signals that tell the cells to multiply too quickly. Aromatase inhibitors are used to treat hormone receptor-positive early, locally advanced, and metastatic breast cancers.

Patients and treatment

Approximately 30% of women diagnosed with early-stage breast cancer subsequently develop advanced or metastatic cancer (4). Currently, it is estimated that 155,000 women with metastatic breast cancer are living in the United States (5). The lifetime cost per patient for those treated with tamoxifen, AI five years, and switch therapy were ₹14,72,037 (I$68,948), ₹13,06,795 (I$61,208) and ₹12,81,350 (I$60,016), respectively. The incremental cost per patient when tamoxifen was compared with AI and switch therapy was ₹1,65,242 (I$7740) and ₹1,90,226 (I$ 8909), respectively.

Conversely, any medication that inhibits CYP3A4 will prevent the metabolism of exemestane, increasing serum concentrations, which may lead to increased side effects. Patients and providers should be aware of any estrogen-containing products the patient is taking. These products should be avoided while on hormone deprivation therapy, as they could potentially counteract the benefits from AIs. Networks for treatment duration were not available, so MONARCH 3 data were used for abemaciclib (with an aromatase inhibitor) and an aromatase inhibitor alone. Data from the summary of product characteristics were used for palbociclib and ribociclib.

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Here are answers to some frequently asked questions about drug cost and exemestane. Factors that may affect the price https://www.itonksphoto.com/2025/02/21/steroids-understanding-their-uses-and-risks-4/ you’ll pay include your treatment plan, your insurance coverage, and the pharmacy you use. When the time horizon was reduced to a 5-year horizon for the comparison between ABE + FUL and PAL + FUL, the ICER decreased to $26,422 per QALY.