Outcomes of Anastrozole, Letrozole, and Exemestane in Patients With Postmenopausal Breast Cancer

Are there differences in the clinical outcomes associated with anastrozole, letrozole, and exemestane as adjuvant endocrine therapy in women with postmenopausal hormone receptor–positive early-stage breast cancer?In this comparative effectiveness study emulating a target trial and including 148 436 postmenopausal women in France, exemestane was associated with lower disease-free survival and overall survival after 8 years compared with anastrozole and letrozole, both under natural and perfect persistence.These findings suggest higher risks of recurrence and death with exemestane and thus may favor anastrozole and letrozole as initial treatment; future studies may inform aromatase inhibitor molecule selection in clinical practice.

Corresponding Author: Elise Dumas, PhD, EPFL SB MATH BIOSTAT (Bâtiment MA), Station 8 CH-1015 Lausanne, Switzerland (elise.dumas28@gmail.com).

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