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cc by-nc-nd (c) Giralt, Marina et al, 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/222839

Analytical Interference of Exemestane With Androstenedione Immunoassays

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Background: Exemestane, an aromatase inhibitor commonly used for breast cancer treat- ment, shares structural similarities with sex steroids analyzed in clinical laboratories. We aimed to investigate the influence of exemestane cross-reactivity in the measurement of sex steroids across various immunoassays. Methods: We conducted a multicenter study involving measurements of androstenedione, testosterone, estradiol, progesterone , 17-hydroxyprogesterone in serum samples from women undergoing exemestane therapy (N =15; 25 mg/day). Measurements were per- formed using liquid chromatography-mass spectrometry (LC-MS) , various commercially available chemiluminescence immunoassays, ELISA, and radioimmunoassay. In-vitro cross-reactivity was assessed by adding exemestane and 17-hydroexemestane to serum samples. Results: Patients undergoing exemestane therapy had markedly falsely elevated andro- stenedione results in all immunoassays evaluated (N = 4), which correlated with serum ex- emestane levels. In-vitro experiments confirmed this interference to be caused by cross-re- activity with exemestane. Additionally, one immunoassay yielded falsely elevated estradiol results in 20% of patients. However, in-vitro experiments did not confirm this to be caused by cross-reactivity with exemestane or 17-hydroexemestane. Conclusions: Exemestane cross-reacts with androstenedione immunoassays, causing falsely elevated results in treated patients. This analytical interference may raise unneces- sary concerns, leading to expensive diagnostic workups.

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GIRALT, Marina, FERRER, Roser, DÍAZ TROYANO, Noelia, VEGA, Belén, LUQUE RAMÍREZ, Manuel, MARTÍNEZ, Sílvia, FERNÁNDEZ, Bárbara, MARTÍNEZ, Irene, FABREGAT, Aleix, URGELL, Eulàlia, CARDONA, Ignasi, CASALS, Gregori, ESCOBAR MORREALE, Héctor f.. Analytical Interference of Exemestane With Androstenedione Immunoassays. _Annals of Laboratory Medicine_. 2025. Vol. 45, núm. 4, pàgs. 410-419. [consulta: 21 de gener de 2026]. ISSN: 2234-3814. [Disponible a: https://hdl.handle.net/2445/222839]

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