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BIIB021 + exemestane is a combination of two drugs: **BIIB021**, a fully synthetic, orally available small molecule inhibitor of heat shock protein 90 (Hsp90), and **exemestane**, an oral irreversible aromatase inhibitor. **BIIB021** inhibits Hsp90 by binding competitively to the ATP-binding pocket, leading to misfolding and degradation of client oncoproteins such as HER-2, AKT, and Raf-1, resulting in the inhibition of cancer cell proliferation and survival. **Exemestane** irreversibly inhibits the enzyme aromatase, suppressing estrogen biosynthesis, which is a key growth factor in hormone-sensitive breast cancers. This combination is being investigated for anti-tumor activity, particularly in estrogen receptor-positive breast cancer, utilizing complementary mechanisms targeting both Hsp90-client oncoprotein pathways and estrogen synthesis[2].
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