From a quality of life perspective, there is no strong indication to favor either exemestane plus ovarian function suppression (OFS) or tamoxifen plus OFS for the treatment of premenopausal women with early breast cancer, a new study published online ahead of print this week in the journal The Lancet Oncology has shown.

For the study, researchers conducted a combined analysis of TEXT and SOFT, two phase III randomized trials, to evaluate patient-reported outcomes after treatment with tamoxifen plus OFS or exemestane plus OFS.

In the two studies combined, 4,717 premenopausal women with hormone receptor-positive breast cancer were assigned to receive adjuvant treatment with 5 years of exemestane plus OFS or tamoxifen plus OFS.

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Results showed that patients who received tamoxifen had a higher risk for hot flushes and sweats over the study period than those on exemestane; however, these symptoms improved.

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On the other hand, patients on exemestane more frequently experienced vaginal dryness, greater loss of sexual interest, and difficulties becoming aroused that those treated with tamoxifen.

Patients receiving exemestane also experienced a more pronounced increase in bone or joint pain, especially in the short term. Global quality of life indicators were similar between both groups during the 5 years.


  1. Bernhad JJ, Luo W, Ribi K, et al. Patient-reported outcomes with adjuvant exemestane versus tamoxifen in premenopausal women with early breast cancer undergoing ovarian suppression (TEXT and SOFT): a combined analysis of two phase 3 randomised trials. Lancet Oncol. 2015. [Epub ahead of print]. doi: 10.1016/S1470-2045(15)00049-2.