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Exemestane is a steroidal aromatase inhibitor, the partner of everolimus and the agent tested with ovarian suppression in young women.
Exemestane is a steroidal aromatase inactivator: it binds aromatase irreversibly as a 'suicide' substrate, permanently disabling the enzyme that makes oestrogen from androgens in postmenopausal women. It is used in hormone receptor-positive breast cancer after failure of a non-steroidal aromatase inhibitor, as the partner of everolimus (BOLERO-2), and with ovarian function suppression in premenopausal women (TEXT). In the combined SOFT and TEXT analysis, exemestane plus OFS improved 12-year disease-free survival over tamoxifen plus OFS (80.5% versus 75.9%, HR 0.79) without an overall survival difference. It is taken as 25 mg once daily after a meal and is generic. Whether its steroidal structure gives a real advantage after non-steroidal AI failure is not settled. For a newcomer, exemestane is the aromatase inhibitor most often chosen when another one has stopped working.
Irreversible 'suicide' inactivation of aromatase. Connects to Estrogen receptor (ERα).
1.Exemestane acts on Estrogen receptor (ERα), the hormone receptor or the enzyme that makes the hormone.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic.
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE search: exemestane. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Region | Year | Indication |
|---|---|---|
| US | 1999 | Advanced breast cancer after tamoxifen |
| US | 2005 | Adjuvant after 2-3 years of tamoxifen |
Read for the class this product belongs to (aromatase inhibitors) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
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Query for this drug: (TITLE:"Exemestane" OR ABSTRACT:"Exemestane" OR TITLE:"Aromasin" OR ABSTRACT:"Aromasin") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Exemestane, not a curated reading list.
Shares Ovarian Suppression Evaluating Subcutaneous Leuprolide Acetate in Breast Cancer, A Study of Camizestrant in ER+/HER2- Early Breast Cancer After at Least 2 Years of Standard Adjuvant Endocrine Therapy, A Study of Elacestrant Versus Standard Endocrine Therapy in Women and Men With ER+,HER2-, Early Breast Cancer With High Risk of Recurrence, A Study of Imlunestrant Versus Standard Endocrine Therapy in Participants With Early Breast Cancer.
Shares Aromatase (CYP19A1), Antiandrogens for hair: spironolactone, finasteride, dutasteride, Aminoglutethimide, Acupuncture for aromatase-inhibitor joint pain.
Shares Acupuncture for aromatase-inhibitor joint pain, Acupuncture for hot flushes on endocrine therapy, Vaginal oestrogen after breast cancer: what the evidence says, and where it disagrees, Menopause brought on by cancer treatment, and the options for it.
Shares Ovarian function suppression (OFS), SOFT & TEXT, Menopause brought on by cancer treatment, and the options for it, Bone loss caused by cancer treatment, and what rebuilds it.
Shares A Study of Imlunestrant Versus Standard Endocrine Therapy in Participants With Early Breast Cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, Estrogen receptor (ERα), Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test.
Shares evERA, High-risk early HR-positive breast cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, Estrogen receptor (ERα).
Shares A Study of Elacestrant Versus Standard Endocrine Therapy in Women and Men With ER+,HER2-, Early Breast Cancer With High Risk of Recurrence, Phase 1/2 Study to Evaluate EP0062 as Monotherapy and in Combination in Patients With Advanced or Metastatic AR+/HER-2-/ER+ Breast Cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, Estrogen receptor (ERα).
Shares Sirolimus for Injection (Albumin-bound) in Combination With Endocrine Therapy for HR+/HER2- Advanced/Metastatic Breast Cancer Patients Who Have Failed Standard Therapy, OP-1250 (Palazestrant) vs. Standard of Care for the Treatment of ER+/HER2- Advanced Breast Cancer, A Study of MK-5684 in People With Certain Solid Tumors (MK-5684-015/OMAHA-015), First-in-Human Study of Tersolisib (STX-478) as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors.