aromatase inhibitors, femara or arimidex

[Diane H]

Am interested to know which hormonal blocker is taken, I am on femara. It seems all I hear about is arimidex though, is there an advantage in taking one over the other depending on situation?

[kristen8594]

Hi Diane,

I have no information for you, but I will be interested in how others respond. I have been on tamoxifen for just over two years and still am not post menopausal. Although my oncol thinks by this time next year I will be because it has been very sparse lately. She has told me that I should start thinking about switching over between femora, or one of the other newer drugs. So I will be interested in hearing how others compare these drugs.
How are we supposed to know which one is right for us???
Kristen

[panicked911]

I was just switched off tomaxifen and put on arimidex - b/c of the Her2++ status I was put into menapaus w/ luprene shots. My onc said arimidex is the dug of choice basd on info leared at San Antonio - it supposedly workes btter for those of us who are her2++ and fr those akig Hercpetain. If the patient is experiencing a bad reaction of arimidex then femera or one of the others should be tried .

Hope this helps

[Rupali]

Hi,

Is there a link that says armidex is better for Her2 patients taking Herceptin as I will like to present that to my oncologist.

Regards,
Rupali

I am no expert on but questions I would look at are;

1. The risk of Tamoxifen causing growth (see below - and I have seen it suggested elsewhere)
2. The side effects of the two. I have posted some links on the menstural cycle post and try looking at Breastcancer.org who have an informative section comparing the side effect of the two. There are big differences in side effects, among others risks of secondary cancers for tamoxifen and bone degredation with arimidex.
3. Generally arimidex is only perscribed to post menopausal which presents another set of issues for those who are premenopausal. For fertile women the issues are life changing and very complex.
4. Out come statistics I have seen seem to suggest arimidex has better (significantly) outcomes statisticaly that tamoxifen.
5. Your fertility views.
6. Your menopause views.
7. Your risk factors.
8. Insurance and cost aspects factors (arimidex from memory is a lot more expensive)

The more one reads the more complex it all is. As somebody who was a total beginner at the begining of the year I can only recommend you read and read and read. Regretably you are not going to find the answers neatly writen out all in one place. Change is happening so fast, opinons vary, regiems in countries and hospitals vary, the level of knowledge in practicioners varies depending on specialism..... An echo of a song comes to mind "it was all so simple then.. but time has rewritten every line".....the cancer learning process is a bit like that.

If you have not had a chance to skin through my lengthy links on the menstal cycle post please do they are thought provoking, and represent a few saved out of very many searches. The first three deal with treatment impact issues on your age group.

As always I am strictly amatuer, all I can do is provoke possible directions of exploration and provide a few links, and wonder why the health profession does not try / manage to provide easier access to guidance on these fundamantal issues.

The information you are seeking does not come in neat packages. I wish it was all so clear cut and effective that it did.

If this seems a bit sharp please excuse me I do not mean to be, the emotional toll of the decisions you are making is unimaginable for me, and I feel indignation for you that the answers are not there, but from all my reading there is no easy way but to spend the time to read it all up if you are the sort of person who needs to understand and know.

RB







http://www.thelocal.se/article.php?I...&date=20050901

Breast cancer drug "can stimulate tumour growth"

Published: 1st September 2005 10:26 CET

A drug prescribed to more than half of all patients suffering from breast cancer can in some cases actually stimulate tumour growth and increase the likelihood of a relapse, Swedish researchers said on Thursday.

The drug, tamoxifen, has since the 1970s been widely prescribed to fight breast cancer since it has shown to counteract the cancer-promoting effects of estrogen in the breast by binding itself to the estrogen receptor in the cancerous cell, thus impeding tumour growth.

According to new research conducted at the Malmö University Hospital, UMAS, in southern Sweden however, the drug can have the opposite effect on certain types of tumours.

"The result shows that tamoxifen is a very efficient treatment for most patients. But for 15 percent of tumours that contain many copies of the cell-splitting gene cyclin D1 tamoxifen however appears to have the opposite effect," researcher Karin Jirström said in a statement.

The study conducted by Jirström and her colleagues was based on examinations of patients from southern Sweden who had been treated with the drug. It was recently published in the US medical journal Cancer Researcher.

"It is important not to draw the conclusion of this study too far ... But this is the first time that patients have been identified on whom the treatment has had the opposite effect," researcher Göran Landberg said in the statement.

"Our findings in Malmö should immediately be tested in other studies to avoid negative effects of this otherwise very effective drug tamoxifen," he added.

AFP

[Diane H]

I agree completely, for me the best thing is to read whatever I can get my hands on that might have some relevance. Unfortunately I don't always understand what I'm reading! I think it is pretty clear that an aromatase inhibitor is called for when one is definitely post menopausal. And I too have heard that tamoxifen may not work well with herceptin. What I haven't been able to pin down is which aromatase inhibitor works best in which situation. Many thanks for the links, and the sharing of research. Still interested in what aromatase inhibitor everyone is taking, arimidex or femara---

[sassy]

I'm show post meno, but taking Lupron to make sure I stay that way. Have been on Arimidex for about two months. My once said his is AI is choice because they have the most info on its track record. I'm also taking fosamex to help stave off bone loss, but feel like it is causing significant joint pain. Would be interested in knowing if anyone else is taking something to help with bone loss and any side effects.

Sassy
________
Buy Bubblers

[panicked911]

my onc suggested that I take citrical - its over the counter 600 mg in the a.m. 600 in the p.m. to stave off bone loss as i too, am on arimidex and luprone

[Ginagce]

I completed ac/taxol chemo in Feb05 and immediately started arimidex. I was premenopausal when I started chemo, based on hormone tests and the lack of any period whatsoever, postmenopausal when I was done.

My oncologist has stated that there is no difference in success in the arimidex versus the femara. I've only just started to research the data on femara vs arimidex as I am considering switching to the femara.

Will be interested to hear from others and will share any research I find on the topic.

Best wishes to you. These decisions are killers. I remember when I was first diagnosed with breast cancer back in 97. Because of my circumstances at the time, I went to 3 separate cancer centers for recommendations. I got 3 completely different answers. All were NCI centers, all renowned for bc care.

I sometimes wonder why in this day and age when we know more about breast cancer than ever, there is no definite answer to some questions. Then I realize the complexities of every breast cancer and I know why it is so hard.

Once again thank god for the people on sites like these who share their knowledge and experiences.

Ginagce

[Ginagce]

Forgot to add, I take the above to ward off bone loss. My oncologist has not suggested I do anything further. However I am concerned about this issue. Both my mother and grandmother had osteoporosis.

Ginagce

[Becky]

The reason doctors prefer Arimidex is that there are studies that prove that Arimidex works better than Tamoxifen head to head (ie: some women in the study took Taxoxifen and the others Arimidex).


Studies on the other 2 AIs (Femara and Aromosin) studied women who took 2 years of Tamoxifen and then half stayed on Tamoxifen and the other half were switched to Femara (another study switched half the women to Aromosin). These studies showed that the women who took 2 years of Tamoxifen then switched to an AI did better. Therefore, the other 2 were not proved (yet) to be better than Tamoxifen from the get go but were better than staying on Tamoxifen.

Femara also had another study that women who did their 5 years of Tamoxifen and then went on 5 years of Femara did better than women who did not (go on Femara after Tamoxifen).

This is the only reason doctors "like" Arimidex better (right now) and that's because of studies (Arimidex worked better without taking Tamoxifen first - however Femara and Aromosin studies will probably prove the same thing but doctors absolutely like proof - as we know LOL).

However, if Arimidex is giving you problems, I would definitely explore the others.

I got an oophorectomy in order to take Arimidex (along with adjuvant Herceptin).

Happy Holidays

Becky

[Ginagce]

I have considering switching from Arimidex to Femara to see if the side effects were any better but do not want to lose any of the effectiveness of Arimidex. Good info you shared.

Thanks and Happy Holidays to you and yours.

Ginagce

[jsattaw]

I'm on Arimidex too -- had a total hysterectomy in early November and am in my first month on Arimedex. I know there's a study exploring the effectiveness of the three major AIs -- I really don't know the reason why my onc preferred Arimidex ...

Jill

[sarah]

Here in France, my onc put me on Femara to take at night for less side effects. (My nails break but not any unbearable side effects.) He's one of the most famous here and travels constantly around the world to conferences so is generally up to date. next time I see him, I'll try to see why Femara over the other AIs. Also he didn't put me on any extra bone stuff because he wants to "save that" in case it's needed. I'll have a bone density test in jaunuary which should show if it's had a bad effect or not. I'm still on Herceptin and hoping and praying to stay on it. I'll also be curious to know what's he's learnt about the ER+ and PR+ equation. I'll be curious to hear if any of you learn more also.sarah

[Susan]

My onc put me on Fasolex, I guess I didin't relize all the different drug options. I've only had 2 herceptin doses, and i'm going for my second shot of faslodex this week. I was premen before chemo, but haven't had a period since sept. the doctor said that according to my drug tests, I'm still premen....What's the difference between arimidex and fasloex?

Sue

[Diane H]

Special thanks to Becky, great studies you shared. I talked to my Dr. with Kaiser and he states arimidex and femara are basically similiar. They have a deal going with Femara so prefer to prescribe that. Now I am not all that confident in my Drs opinion so will continue to search for more info.

[Becky]

Diane H - your doctor is right in that Arimidex and Femara work on inhibiting the same part of the (bio)chemical reaction where aromatase converts androgens into estrogen. Aromosin works on a different part of the reaction to prevent the synthesis of estrogen. Femara and Arimidex are non-steroidal and Aromosin is steroidal and the mechanisms are different but the end result is the same (no estrogen production in the adrenal glands or fat cells).

Faslodex is very much like Tamoxifen (blocks the estrogen receptors on the surface of breast cancer cells so estrogen cannot attach and signal cell growth and division). Arimidex and all AI's inhibit estrogen production outside of the ovaries (which is why you have to be post menopausal to take an AI). Thereby - no estrogen to bind to the estrogen receptor.

Take care

Becky

[Annemarie]

I am on Lupron and Femara. My oncologist put me on Femara because he said they have the most data. He sees them as very similar in the class. He switches pts. around if they fail on one.

[Lyn]

Hi, I was not hormone responsive so it was not an issue to try Tamoxefin, I tried Femara as I went into early menopause from the chemo but it did nothing for me, later down the track I tried Aromasin and it shrunk some enlarged lymphs in my neck. I was told that Aromasin is one of the preferred drugs used when Tamoxefin no longer works. I had a friend on Tamoxefin for 12 months and for the whole time she had breathing problems and unbeknown she was developing clots on her lungs but this was not detected until she had 6 and it became a big issue, they were found when a CT was done while lying on her stomach. It seems that as our status can change it is a matter of trial and error, I know the Aromasin for me stopped eostrogen growing because I had to use Ovastin cream when I had a PAP smear and then it would come back normal.

Love & Hugs Lyn

[Barbara2]

I started Arimidex in April of 03. Am also getting "late" herceptin; about 7 month's worth so far. Have been taking Actonel ( a type of bisphosphenate used to treat osteoporosis) because bone density scan shows I now have osteopenia. Also take Calcium with vitamin D.

Have had body aches since initial treatment of CEF. Most of the main aches are around the ribs. I always hope these aches are from the medicine and from time to time I fret about it..........

Blessings. Barbara