Combinatie exemestaan en everolimus effectief maar soms toxisch

The combination of exemestane and everolimus is a new treatment option for metastatic hormone-sensitive breast cancer. This treatment is used after progression on non-steroidal aromatase inhibitors. The treatment is generally well tolerated, but sometimes leads to minor or even serious side effects. It is important to be aware of these side effects and to treat them. We describe two patients who had to cope with various forms of toxicity: a 73-year-old woman with aphthous mouth lesions and a 49-year-old woman with pneumonitis. We then discuss the efficacy of the combination exemestane and everolimus and its positioning in the treatment of metastatic hormone-sensitive breast cancer. Finally, some common and some potentially serious side effects will be discussed, along with recommendations for their management and indications for distinguishing side effects from disease progression.

Conflict of interest and financial support for this article: V.C.G. Tjan-Heijnen has received a grant from Novartis for a registry on metastatic breast cancer in centres in the South East Netherlands that provided insight into the quality of endocrine treatment and prognostic factors.