effectiveness?
 

Does anyone know how effective Femara is (or the other "5 year" drugs such as Arimidex or Aromasin)? My onc put me on it but didn't really explain how much it will help.

Re: effectiveness?
 

In head to head studies the AIs (of which femara is one, as well as the other mentioned are all same class of drug) performed better than 5 years of Tamoxifen in preventing recurrence, but one must be post-menopausal to receive it.

Re: effectiveness?
 

My cancer is not oestrogen receptor positive, so I don't take these, but I just heard of apremenopausal woman being given another drug to put her through menopause so she could then take AIs because she could not tolerate Tamoxifen. (If she got the story straight and I remembered it straight)

Re: effectiveness?
 

Hi Lisalou- Thanks for your response. Do you have any idea what "performed better" translates to in actual numbers? A 5% increase or maybe a 25% increase? Apparently I am one of those people that needs to know specifics so I can judge if there is a diminishing return on my investment so to speak. Is taking Femara worth the side effects. My onc team typically tells me I am receiving the "Gold Standard" of treatment but that really doesn't tell me much. Seems like if jumping off a bridge was the gold standard I'd be doing that too! I probably think too much - what if? what about?

Re: effectiveness?
 

Donna

How er and pr positive are you?

Re: effectiveness?
 

Hi Becky -
I have no idea and I feel pretty silly not knowing. Does that effect or change how effective Femara is or how necessary it is?

Re: effectiveness?
 

Yes, it does. Your pathology report should have something on there about it

Re: effectiveness?
 

Hi Becky-
I have my path report although I think it is written in a foreign language. Is this what you were asking - estrogen receptor positive, progestorone positve, HER2+. It is invasive ductal carcinoma, nottingham grade 3, glandular score 3, nuclear pleomorphism score 3 and mitotic rate score 2. No node involvement. I probably should have really read the report many months ago - unfortunately we sold our house and moved (8 hours away, different state), then my Dad died and my Mom moved in with us right after my surgeries. Then I started chemo etc. It's been a wild ride!

Re: effectiveness?
 

Yes. Alot of times it says how positive you are. For example, i am 50% estrogen poaitive but I am progesterone negative. Anyway, all "antihormonals" work best of you are positive for both which you are. I dont know the stats on survival improvement but it is significant as hormone positive cancer tends to recur later in the game. There is always an early peak but unlike hormone negative bc, there is a 5-8 year second peak. This peak is oddly about when the 5 years of tamoxifen/femara type drugs is over. Hence studies to take it 10 years. The 10 year tamoxifen study shows the 10 years is only marginally better at ten years but 10 years has a significant carryover effect. Giving added protection for many years thereafter. I highly recommend therapy. I have been on Arimidex for 9.5 years. I am figuring in september my doc will take me off. If you have side effects when on femara, you can switch to arimidex or aromoson or even tamoxifen. There is risk reduction but i cant tell you what it is

Re: effectiveness?
 

I was 100% estrogen receptor positive, 1% progesterone positive and Her2 2+. On another page it lists the Pathologic Staging as pT2, N0 (sn), i- M-N/A

Re: effectiveness?
 

In large groups of ERPR positive women, the benefit of endocrine therapy (AIs, Tamoxifen) is probably in the area of 30-50% relative reduction in recurrence. But as others have said, it's believed that the benefit may be higher for cancers that are highly ER+ and lower for those that are less ER+. Plus there's new information (and more to come) about the benefits of endocrine therapy continued beyond 5 years.

But that is only the relative risk reduction, and that has to be factored into your individual risk of recurrence (factoring in stage and other details of the cancer), to get the absolute benefit to you.

For example, if a woman completed treatment with a 50% chance of recurrence, and then did endocrine treatment that reduced her risk by 50%, she would be left with a 25% absolute risk of recurrence. Another woman with a 5% risk of recurrence after treatment would have that reduced to 2.5% with the same treatment. IOW, the higher your risk of recurrence is, the more absolute benefit you will gain from any treatment.

Your oncologist is the one to ask for these numbers. Again, they will have been garnered from large groups of women who may not be exactly matched to your individual cancer details, but they will be the closest we can get, and helpful in making treatment decisions.

Here's a quotation from a fairly-recent (12/2013) article regarding 5 years of Tamoxifen: "In the most recent Oxford overview of women with estrogen receptor (ER)-positive breast cancer, which included 15 years of follow-up, use of 5 years of adjuvant tamoxifen (compared with no therapy) resulted in a halving of recurrence rates during years 0 through 4, and a reduction by one-third in years 5 through 9." The article is actually discussing duration of therapy (and there is newer data also supporting longer therapy), but it has some useful information for your question:

Adjuvant Endocrine Therapy for Breast Cancer: How Long Is Long Enough?

But again, you should ask your oncologist to go over this with you. It could probably be done with a phone call.

Debbie Laxague

Re: effectiveness?
 

Today they are suggesting AIs be taken for 10 years so after 5 years, ask your doctor about that. Also try taking the pill at night.
take care
sarah

Re: effectiveness?
 

When did most start taking Femara (or other AI) - while still getting Herceptin or after? After chemo finished or while chemo?

Re: effectiveness?
 

I started after radiation - after chemo and during Herceptin

Re: effectiveness?
 

I just switched from Tamoxifen to Femara. I was put on Tamoxifen and had some side effects I didn't care for. Had blood tested for post-menopausal status (which we all figured I probably was) and I am. So I switched to Femara. So far, I don't notice side effects.

Just was talking to my Oncologist about this so here are the notes I have...

Femara (and assuming all AI's) has a slight advantage on risk of recurrence percentages for post-meno women. If (*if*) one had a 100% likelihood of recurrence, taking Tamoxifen (which is ok for post-meno women to use) cuts that risk by 51%. If one had a 100% likelihood of recurrence, taking Femara cuts that risk by 54%. (Assuming we might have less than a 100% likelihood of recurrence, then the risk goes even lower, of course).

Anyway, the difference between Tamoxifen & AI is 3% advantage to the AI. May not seem huge, but 3% is 3%!

For post-meno women who cannot tolerate the AI, then going back to Tamoxifen makes sense because then, rather than taking nothing and losing all that 50+% advantage, you are getting 51% advantage.

Cheers,
Lizz.

Re: effectiveness?
 

My doctor started me on Arimidex right after chemo and while still on Herceptin ... but I had had another ER/PR + tumor that wasn't also HER2+++ to worry about in the other breast (see my signature). He told me he didn't want to give the other tumor any window of opportunity. Both of my tumors were very strongly estrogen positive.

Carol Ann