Would you consider exemestane (instead of fulvestrant) in post-menopausal patients with hormone receptor pos, HER2- breast cancer who progress on letrozole or anastrozole?

Generally would not. I usually do Fulvestrant +/- CDK inhibitor if not received in the first line setting, as second line and reserve exemestane to afterwards combined with everolimus. If a patient has minimal disease progression on letrozole/anastrozole and really does not want a monthly injection, then that would be a scenario for which I would consider exemestane. Otherwise, I consider exemestane to be too similar to letrozole/anastrozole and not one likely to provide a response alone when th...