NSABP Members' Area
  Password Protected - Access
  Limited to NSABP Participating
  Institutions Only


NSABP Foundation, Inc.



General NSABP Information
  Financial Conflicts of
     Interest Policy
  Coalition Comment:
     Reconfiguration
  IOM Report Group Comment
  Contact the NSABP
  Pathology Section
  Future Meetings
  NSABP Newsletters
  Media Info on STAR
  Employment

Clinical Trials Information
  Clinical Trials Overview
  Protocol Chart
  Never Say Lost

Treatment Trials Information
  Protocol B-43
  Protocol B-47
  Protocol B-51

Prevention Trials Information
  Protocol P-1 - BCPT
  Protocol P-2 - STAR
  Protocol P-5
  BreastCancerPrevention.com

Scientific Publications

Related Web Sites



Medical Search Engines



To report problems, ask
questions or make comments,
please send e-mail to:
Webmaster@nsabp.pitt.edu

Annotated Bibliography of NSABP Publications


Benefit From Exemestane as Extended Adjuvant Therapy Following Five Years of Adjuvant Tamoxifen: Intent-to-Treat Analysis of the National Surgical Adjuvant Breast and Bowel Project B-33 Trial.
Mamounas EP, Jeong J, Wickerham DL, Smith RE, Ganz PA, Land SR, Eisen A, Fehrenbacher L, Farrar WB, Atkins J, Pajon ER Jr, Vogel VG, Kroener JF, Hutchins L, Robidoux A, Hoehn JL, Ingle JN, Geyer CE Jr, Costantino JP, Wolmark N.
J Clin Oncol. 2008 Apr 20;26(12):1965-71. Epub 2008 Mar 10.

Abstract
Purpose: Patients with early-stage, hormone receptor-positive breast cancer have considerable residual risk for recurrence after completing 5 years of adjuvant tamoxifen. In May 2001, the National Surgical Adjuvant Breast and Bowel Project (NSABP) initiated accrual to a randomized, placebo-controlled, double-blind clinical trial to evaluate the steroidal aromatase inhibitor exemestane as extended adjuvant therapy in this setting.

Patients and Methods: Postmenopausal patients with clinical T(1-3)N(1)M(0) breast cancer who were disease free after 5 years of tamoxifen were randomly assigned to 5 years of exemestane (25 mg/d orally) or 5 years of placebo. Our primary aim was to test whether exemestane prolongs disease-free survival (DFS). In October 2003, results of National Cancer Institute of Canada (NCIC) MA.17 showing benefit from adjuvant letrozole in this setting necessitated termination of accrual to B-33, unblinding, and offering of exemestane to patients in the placebo group.

Results: At the time of unblinding, 1,598 patients had been randomly assigned; 72% in the exemestane group continued on exemestane and 44% in the placebo group elected to receive exemestane. With 30 months of median follow-up, original exemestane assignment resulted in a borderline statistically significant improvement in 4-year DFS (91% v 89%; relative risk [RR] = 0.68; P = .07) and in a statistically significant improvement in 4-year relapse-free survival (RFS; 96% v 94%; RR = 0.44; P = .004). Toxicity, assessed up to time of unblinding, was acceptable for the adjuvant setting.

Conclusion: Despite premature closure and crossover to exemestane by a substantial proportion of patients, original exemestane assignment resulted in non-statistically significant improvement in DFS and in statistically significant improvement in RFS.


PMID: 18332472