Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C20H24O2 |
| Molecular Weight | 296.4034 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 5 / 5 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
C[C@]12CC[C@H]3[C@@H](CC(=C)C4=CC(=O)C=C[C@]34C)[C@@H]1CCC2=O
InChI
InChIKey=BFYIZQONLCFLEV-DAELLWKTSA-N
InChI=1S/C20H24O2/c1-12-10-14-15-4-5-18(22)20(15,3)9-7-16(14)19(2)8-6-13(21)11-17(12)19/h6,8,11,14-16H,1,4-5,7,9-10H2,2-3H3/t14-,15-,16-,19+,20-/m0/s1
| Molecular Formula | C20H24O2 |
| Molecular Weight | 296.4034 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 5 / 5 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
DescriptionSources: http://www.drugbank.ca/drugs/DB00990Curator's Comment: Description was created based on several sources, including
https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020753s009s011s012lbl.pdf
Sources: http://www.drugbank.ca/drugs/DB00990
Curator's Comment: Description was created based on several sources, including
https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020753s009s011s012lbl.pdf
Exemestane is an oral steroidal aromatase inhibitor used in the adjuvant treatment of hormonally-responsive (also called hormone-receptor-positive, estrogen-responsive) breast cancer in postmenopausal women. It acts as a false substrate for the aromatase enzyme, and is processed to an intermediate that binds irreversibly to the active site of the enzyme causing its inactivation. Breast cancer cell growth may be estrogen-dependent. Aromatase (exemestane) is the principal enzyme that converts androgens to estrogens both in pre- and postmenopausal women. While the main source of estrogen (primarily estradiol) is the ovary in premenopausal women, the principal source of circulating estrogens in postmenopausal women is from conversion of adrenal and ovarian androgens (androstenedione and testosterone) to estrogens (estrone and estradiol) by the aromatase enzyme in peripheral tissues. Estrogen deprivation through aromatase inhibition is an effective and selective treatment for some postmenopausal patients with hormone-dependent breast cancer. Exemestane is an irreversible, steroidal aromatase inactivator, structurally related to the natural substrate androstenedione. It acts as a false substrate for the aromatase enzyme, and is processed to an intermediate that binds irreversibly to the active site of the enzyme causing its inactivation, an effect also known as "suicide inhibition". Exemestane significantly lowers circulating estrogen concentrations in postmenopausal women, but has no detectable effect on the adrenal biosynthesis of corticosteroids or aldosterone. This reduction in serum and tumor concentrations of estrogen delays tumor growth and disease progression. Exemestane has no effect on other enzymes involved in the steroidogenic pathway up to a concentration at least 600 times higher than that inhibiting the aromatase enzyme. Exemestane is marketed under the trade name Aromasin.
Originator
Sources: http://adisinsight.springer.com/drugs/800000826
Curator's Comment: # Pfizer
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL1978 Sources: https://www.ncbi.nlm.nih.gov/pubmed/22951074 |
50.1 nM [IC50] | ||
Target ID: CHEMBL387 Sources: https://www.ncbi.nlm.nih.gov/pubmed/25738757 |
28.02 µM [IC50] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | Aromasin Approved UseAROMASIN is an aromatase inhibitor indicated for:
adjuvant treatment of postmenopausal women with estrogen-receptor positive early breast cancer who have received two to three years of tamoxifen and are switched to AROMASIN for completion of a total of five consecutive years of adjuvant hormonal therapy.
the treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy Launch Date1999 |
|||
| Primary | Aromasin Approved UseAROMASIN is an aromatase inhibitor indicated for:
adjuvant treatment of postmenopausal women with estrogen-receptor positive early breast cancer who have received two to three years of tamoxifen and are switched to AROMASIN for completion of a total of five consecutive years of adjuvant hormonal therapy.
the treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy Launch Date1999 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
16.1 ng/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14671195 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
EXEMESTANE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
36.4 ng × h/mL EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14671195 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
EXEMESTANE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
8.9 h EXPERIMENT https://www.ncbi.nlm.nih.gov/pubmed/14671195 |
25 mg single, oral dose: 25 mg route of administration: Oral experiment type: SINGLE co-administered: |
EXEMESTANE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
600 mg 1 times / day multiple, oral Highest studied dose Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
unhealthy, 37-77 |
|
800 mg single, oral Highest studied dose |
healthy, 48 - 75 |
|
25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
Disc. AE: Bone density increased, Fetal damage... AEs leading to discontinuation/dose reduction: Bone density increased Sources: Fetal damage |
25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
Disc. AE: Myocardial infarction, Angina... AEs leading to discontinuation/dose reduction: Myocardial infarction Sources: Angina Myocardial ischemia Cardiac failure (0.4%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Bone density increased | Disc. AE | 25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
| Fetal damage | Disc. AE | 25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
| Cardiac failure | 0.4% Disc. AE |
25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
| Angina | Disc. AE | 25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
| Myocardial infarction | Disc. AE | 25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
| Myocardial ischemia | Disc. AE | 25 mg 1 times / day multiple, oral Recommended Dose: 25 mg, 1 times / day Route: oral Route: multiple Dose: 25 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: F Sources: |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Economic evaluation of antiaromatase agents in the second-line treatment of metastatic breast cancer. | 2003-11 |
|
| [Pharmacological and clinical profile of exemestane (Aromasin), a novel irreversible aromatase inhibitor]. | 2003-10 |
|
| Celecoxib anti-aromatase neoadjuvant (CAAN) trial for locally advanced breast cancer: preliminary report. | 2003-09 |
|
| An integrated view of aromatase and its inhibition. | 2003-09 |
|
| Aromatase inhibitors versus tamoxifen for management of postmenopausal breast cancer in the advanced disease and neoadjuvant settings. | 2003-09 |
|
| Aromatase inhibitors as adjuvant therapies in patients with breast cancer. | 2003-09 |
|
| Neoadjuvant comparisons of aromatase inhibitors and tamoxifen: pretreatment determinants of response and on-treatment effect. | 2003-09 |
|
| The intratumoral aromatase model: studies with aromatase inhibitors and antiestrogens. | 2003-09 |
|
| [Clinical trial on exemestane in the treatment of postmenopausal women with advanced breast cancer]. | 2003-09 |
|
| Exemestane seems to stimulate tumour growth in men with prostate carcinoma. | 2003-09 |
|
| Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer. | 2003-09 |
|
| Bone turnover markers and insulin-like growth factor components in metastatic breast cancer: results from a randomised trial of exemestane vs megestrol acetate. | 2003-08-21 |
|
| Aromatase inhibitors in early breast cancer treatment. | 2003-08 |
|
| The role of aromatase inhibitors in the treatment of metastatic breast cancer. | 2003-08 |
|
| Pharmacokinetics of third-generation aromatase inhibitors. | 2003-08 |
|
| Aromatase inhibitors: mechanism of action and role in the treatment of breast cancer. | 2003-08 |
|
| Should aromatase inhibitors replace tamoxifen? | 2003-08 |
|
| Emerging role of aromatase inhibitors in the adjuvant setting. | 2003-08 |
|
| Applicability of the intratumor aromatase preclinical model to predict clinical trial results with endocrine therapy. | 2003-08 |
|
| A comparison of the efficacy of aromatase inhibitors in second-line treatment of metastatic breast cancer. | 2003-08 |
|
| The current status of aromatase inhibitors in the management of breast cancer. | 2003-08 |
|
| Is there a benefit by the sequence anastrozole-formestane for postmenopausal metastatic breast cancer women? | 2003-07 |
|
| A roundtable discussion of aromatase inhibitors as therapy for breast cancer. | 2003-05-20 |
|
| Long-term toxicities of selective estrogen-receptor modulators and antiaromatase agents. | 2003-05 |
|
| Could exemestane affect insulin-like growth factors, interleukin 6 and bone metabolism in postmenopausal advanced breast cancer patients after failure on aminoglutethimide, anastrozole or letrozole? | 2003-05 |
|
| Aromatase inhibitors for treatment of postmenopausal patients with breast cancer. | 2003-04 |
|
| Update on the current use of hormonals as therapy in advanced breast cancer. | 2003-04 |
|
| The role of aromatase inhibitors in early breast cancer. | 2003-04 |
|
| [Treatment of advanced metastatic breast cancer with exemestane, a multicenter randomized controlled study of 195 cases]. | 2003-02-10 |
|
| Clinical differences among the aromatase inhibitors. | 2003-01 |
|
| Pharmacology and pharmacokinetics of the newer generation aromatase inhibitors. | 2003-01 |
|
| Sequential hormonal therapy for metastatic breast cancer after adjuvant tamoxifen or anastrozole. | 2003 |
|
| [Perspectives for the hormonal therapy of breast cancer]. | 2003 |
|
| Advances in endocrine treatments for postmenopausal women with metastatic and early breast cancer. | 2003 |
|
| 8th international conference: primary therapy of early breast cancer, St Gallen, Switzerland, March 12-15 2003. | 2003 |
|
| Exemestane: treatment of breast cancer with selective inactivation of aromatase. | 2002-11-15 |
|
| An overview of the pharmacology and pharmacokinetics of the newer generation aromatase inhibitors anastrozole, letrozole, and exemestane. | 2002-11-01 |
|
| Neoadjuvant endocrine therapy of breast cancer: a surgical perspective. | 2002-11 |
|
| The evolving role of aromatase inhibitors in breast cancer. | 2002-10 |
|
| Sequencing of endocrine therapies in breast cancer--integration of recent data. | 2002-10 |
|
| New generation aromatase inhibitors--from the advanced to the adjuvant setting. | 2002-10 |
|
| The role of aromatase inactivators in the treatment of breast cancer. | 2002-08 |
|
| Overview of the pharmacology of the aromatase inactivator exemestane. | 2002-07 |
|
| [Late phase II study of exemestane in postmenopausal patients with breast cancer resistant to anti-estrogenic agents]. | 2002-07 |
|
| [Early phase II dose-finding study of exemestane in postmenopausal patients with advanced/recurrent breast cancer]. | 2002-07 |
|
| [Phase I multiple-dose administration study of exemestane in postmenopausal women]. | 2002-07 |
|
| [Phase I single-dose administration study of exemestane in postmenopausal women]. | 2002-07 |
|
| Current role of endocrine therapy in the management of breast cancer. | 2002 |
|
| McCune-Albright syndrome--the German experience. | 2002 |
|
| The role of aromasin in the hormonal therapy of breast cancer. | 2002 |
Sample Use Guides
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/25738757
Exemestane (28 uM) inhibits the growth of MCF‑7 cells.
| Substance Class |
Chemical
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NY22HMQ4BX
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LIVERTOX |
NBK548926
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NDF-RT |
N0000175080
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QL02BG06
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FDA ORPHAN DRUG |
60191
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WHO-ATC |
L02BG06
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N0000175563
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C2017
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60198
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CHEMBL1200374
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6770
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EXEMESTANE
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7463
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7073
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DB00990
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m5224
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LL-46
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C056516
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| Related Record | Type | Details | ||
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METABOLIC ENZYME -> SUBSTRATE |
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METABOLIC ENZYME -> SUBSTRATE | |||
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DERIVATIVE -> PARENT |
PLASMA; URINE
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EXCRETED UNCHANGED |
URINE
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METABOLIC ENZYME -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
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BINDER->LIGAND |
BINDING
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DERIVATIVE -> PARENT |
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METABOLIC ENZYME -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE |
| Related Record | Type | Details | ||
|---|---|---|---|---|
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METABOLITE -> PARENT |
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METABOLITE -> PARENT |
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METABOLITE -> PARENT | |||
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METABOLITE -> PARENT |
MAJOR
PLASMA; URINE
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METABOLITE -> PARENT |
MAJOR
PLASMA; URINE
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METABOLITE -> PARENT |
PLASMA; URINE
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| Related Record | Type | Details | ||
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
USP
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ACTIVE MOIETY |
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| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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| Tmax | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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| Biological Half-life | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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| Tmax | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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