I've read on a few posts that combining Tamoxifen and Herceptin actually
is less effective than Herceptin alone, without any hormonal therapy. We're trying to get some mileage out of Tamoxifen prior to switching to an A.I., but if this is the case we won't risk it. Can someone point us to any data that supports this?

Thanks,

Scott

Hi Scott,
The data is in the link in this posting:

http://www.her2support.org/forums/index.ph...ptin++tamoxifen

Regards,
Al

Hi Al,
Thanks for the response. I've read that article before, and while it says that Her2 positive cancers are more resistant to hormonal therapy, Tamoxifen in particular, it actually recommends combining Herceptin with Tamoxifen or to an A.I. to restore sensitivity to the hormonal therapy. In other words, by adding Herceptin you take away the Her2 component of the cancer so it responds like a normal cancer to the hormonal therapy.

A.I.'s have proven to be more effective than Tamoxifen so you would assume that there would be even greater efficacy when combining an A.I. with Herceptin as opposed to Tamoxifen, but in the adjuvant setting you can't take Herceptin for years, at least at this point in time. So we're looking to safely squeeze as much "mileage" out of the Herceptin/Tamoxifen combination before switching to an A.I. where Herceptin will probably be out of the picture at that point.

So, I really haven't come across any hard data from the combination of either of the drugs with Herceptin just theory on why they believe the therapy would be effective. Al, I know you read a lot of articles on this and maybe you can point me to some that have some efficacy data or if anyone else that has come across some data it would be greatly appreciated.

Thanks again,

Scott

Scott: One of the things that has to be taken into account is if you are pre or post menopausal. From what my Onc has said, as long as you are pre-menopausal an aromatase inhibitor won't work for you. I keep having my hormone levels checked but so far I'm stuck with taking Tamoxifen. As soon as I can I will switch to an AI. Take Care, Linda in Calif.

Hi Linda,

My wife actually had her ovaries removed just for the therapeutic value of lowering her estrogen in conjuction with Tamoxifen, and later in anticipation of switching to an A.I. So she's ready for the switch, we're just waiting to pull the trigger. We're hoping to get some initial benefit from Tamoxifen and trying to decide if we want to follow the oncologist's two year recommendation.

You may want to discuss your options about chemically shutting down your ovaries or removing them to speed you into menopause, as it is beneficial even if you were to continue with Tamoxifen. This all depends on your particular situation and prognosis though.

Best of luck,

Scott

Hi Linda

Do you regularly get your FSH/LH levels done? I do and I am still in menopause even though I wasn't before chemo. I get it checked in case I revert back (but I am 46, almost 47 so I probably won't and I might get my ovaries removed because of a persistent cyst that's been there for ages).

I am on Arimedex now and getting weekly Herceptin.

Becky

My Onc and I have been going around and around on the "ovary issue" for the last 2 years. I am 53 and my Onc. feels it is only a matter of a short amount of time until my FSH levels drop and I am post menopausal. He wants to avoid anymore surgery if possible. He feels that the Tamoxifen is doing the same thing that having my ovaries removed would have. I have my hormones checked every 6 months or so. I have reduced my weight by 25 lbs. because I have heard fat produces estrogen, eat a low fat diet and excersize. So I have done what I can, on my own, to minimize the amount of estrogen my body produces. Let's hope that is enough to keep me at NED. Take Care, Linda in Calif.