Anti-estrogen therapy taking too long

KristinSchwick · 11-15-2012, 07:17 PM

Ladies,
How long did it take for your anti-hormonal therapy to bring tumor markers down (when it is effective)?

I've been on aromasin for 3 months and my numbers have been increasing the whole time, but the trend is slowing down- (maybe approaching a plateau???? and then some decreases- I hope soon.)

I'm also on 3 pills Tykerb, Herceptin, Xgeva.

This is the last month he's going to give this therapy a shot- afterwhich I think TDM1 will be our next move.

Lani · 11-17-2012, 12:42 AM

without reviewing the exact articles it seems to me it took many months eg 5-6 or so before they did a repeat biopsy measuring Ki67 and finding it decreasing in the neoadjuvant studies done at Washington University by Matthew Ellis. Perhaps google entrez pubmed and enter neoadjuvant endocrine or Ellis M and see what you get. My memory may be way off.

Sorry not available to search more at the moment.

Saw noone had responded so thought something was better than nothing.

Pray · 11-17-2012, 01:54 AM

Hi Kristen, My Onc. said it takes many months. All though I'm not on anestrozl any longer it took 8 months and my estrogen level alone went down to 16. For an average woman in meno. it is 30. He said when it kicks it it goes all the way. Gods blessings to you. Please know that you are in my prayers.

KristinSchwick · 11-17-2012, 09:20 AM

I should clarify that I've already had my ovaries out (in May) and at that time started femara- this combo seemed to work almost immediately. Now we've seen the numbers climb steadily and have switched to aromasin and the numbers have been jumping up for the last 3 months. The jumps have gotten slightly less over those 3 months. Any thoughts?

Becky · 11-17-2012, 12:33 PM

Although all three AIs reportedly work the same clinically, there are differences on how they work biochemically. Femara and Arimidex work in the exact same biochemical pathway to inhibit the action of aromatase (an enzyme that is needed to facilitate the conversion of androgens to estrogen in the body by either the adrenal gland or body fat - hence why one must be post menopausal to take them because these drugs don't inhibit the production of estrogen by the ovaries).

Aromosin also inhibits aromatase but in an entirely different mechanism.

I have never really seen any of these drugs not work but maybe for you, one mechanism works better than another.

For example, (and I will really have to look to find the study), there is a study on metastatic women who failed on Arimidex. Astra Zeneca was the only maker of this drug at the time (as it is now generic too). So Astra Zeneca (AZ) started a study on women who failed Arimidex. Half of the women went on Faslodex, another AZ drug for ER+ women (but it is a drug that is injected monthly. I think initially a woman needs a shot 2 weeks apart and then monthly thereafter) and the other half of the women switched to Aromosin. The results were equal, both Faslodex and Aromosin worked equally as well for the women it worked for (as you know, any trial drug doesn't work for everyone). So for AZ, this was bad news as they were (I'm sure) hoping that Faslodex would work better than Aromosin since they make Faslodex too. So it was good news for Pfizer (Aromosin's maker) because why wouldn't a woman just not want to switch to another daily pill.

That said, why did you have to switch from Femara? Did it not work well for you or was it side effects? If it was side effects, many women have switched from Femara to Arimidex or vice versa and did see results (less side effects). I am just thinking out loud here for you because if it was side effects, and Femara seemed to be working, maybe it is the biochemical mechanism of which Arimidex's mechanism is the same as Femara's. Otherwise, you also have the advantage of the possibility of Faslodex as well (again ideas to go over with your medical team).

I hope this helps alittle bit. I do tend to sometimes go overboard with the science - that I know!!!