HonCode

Go Back   HER2 Support Group Forums > her2group
Register Gallery FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools Display Modes
Old 07-21-2013, 02:43 PM   #1
tricia keegan
Senior Member
 
tricia keegan's Avatar
 
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Quick question

Does anyone have a link or some info showing ten years on Arimidex is beneficial?? I agreed with my Onc to continue for that time but my friends say they find no evidence in continuing??
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
tricia keegan is offline   Reply With Quote
Old 07-21-2013, 02:51 PM   #2
Sandra in GA
Senior Member
 
Join Date: Aug 2009
Location: Moultrie, GA
Posts: 431
Re: Quick question

Tricia,
I don't have a link, but I do remember hearing that on the news. They quoted a study, but I don't remember who did it.

My late husband was a pharamacist and he always felt it should be given for ten. I know I wish it would benefit me but I am neg to both estrogen and progesteron.

Sandra
__________________
Diagnosed: 7/25/08 ~ age 63, no family history
Surgery: 8/14/08 Bilateral mastectomy; tumor left breast, node dissection; right prophylactic with expanders: 1/12/10 latisimuss dorsi flap on left side: 9/22/10 implants in
Pathology Report: ER/PR-; HER2+ (3+); Grade 3, StageIII; 3cm tumor plus 21/21 lymph nodes positive; 5cm DCIS
Chemo: A/C; Taxol/Herceptin/Tykerb; phase II study at Mayo adding Tykerb for early stage
Radiation: 25 rads
Vaccine: Walter Reed GP2/AE37 vaccine study ~ last booster 9/17/2012
Sandra in GA is offline   Reply With Quote
Old 07-21-2013, 04:01 PM   #3
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Quick question

google showed an ATAC study of 10 years. I couldn't get access but I think one of us her2ers knows how to access.

where's Jackie? she can find anything!
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
'lizbeth is offline   Reply With Quote
Old 07-21-2013, 11:09 PM   #4
karen z
Senior Member
 
Join Date: Apr 2008
Posts: 1,477
Re: Quick question

Results were reported at last year's SABCS on the benefits of 10 years of Tamoxifen. Some have extrapolated from those data. Would like to see studies done on AIs (rather than just extrapolation) but I am not sure they exist as of yet.
karen z is offline   Reply With Quote
Old 07-22-2013, 04:58 AM   #5
Jackie07
Senior Member
 
Jackie07's Avatar
 
Join Date: Jan 2008
Location: "Love never fails."
Posts: 5,808
Re: Quick question

'lizbeth,

Thanks for mentioning me. And thanks to Tricia for asking the question. According to the abstract below, it seems to me only Tamoxifen and Exemestane are recommended for five years:

http://www.ncbi.nlm.nih.gov/pubmed/23835710

Use of Pharmacologic Interventions for Breast Cancer Risk Reduction: American Society of Clinical Oncology Clinical Practice Guideline. Clinical Oncology July 15

Purpose: To update the 2009 American Society of Clinical Oncology guideline on pharmacologic interventions for breast cancer (BC) risk reduction. METHODSA systematic review of randomized controlled trials and meta-analyses published from June 2007 through June 2012 was completed using MEDLINE and Cochrane Collaboration Library. Primary outcome of interest was BC incidence (invasive and noninvasive). Secondary outcomes included BC mortality, adverse events, and net health benefits. Guideline recommendations were revised based on an Update Committee's review of the literature.

Result: tamoxifen, raloxifene, arzoxifene, lasofoxifene, exemestane, and anastrozole. Recommendations: In women at increased risk of BC age ≥ 35 years, tamoxifen (20 mg per day for 5 years) should be discussed as an option to reduce the risk of estrogen receptor (ER) -positive BC. In postmenopausal women, raloxifene (60 mg per day for 5 years) and exemestane (25 mg per day for 5 years) should also be discussed as options for BC risk reduction. Those at increased BC risk are defined as individuals with a 5-year projected absolute risk of BC ≥ 1.66% (based on the National Cancer Institute BC Risk Assessment Tool or an equivalent measure) or women diagnosed with lobular carcinoma in situ. Use of other selective ER modulators or other aromatase inhibitors to lower BC risk is not recommended outside of a clinical trial. Health care providers are encouraged to discuss the option of chemoprevention among women at increased BC risk. The discussion should include the specific risks and benefits associated with each chemopreventive agent.
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe

Last edited by Jackie07; 07-22-2013 at 05:29 AM..
Jackie07 is offline   Reply With Quote
Old 07-22-2013, 05:21 AM   #6
Jackie07
Senior Member
 
Jackie07's Avatar
 
Join Date: Jan 2008
Location: "Love never fails."
Posts: 5,808
Re: Quick question

Here's an abstract for young women:

J Thorac Dis. 2013 Jun;5(Suppl 1):S36-46. doi: 10.3978/j.issn.2072-1439.2013.05.25.
Hormonal therapies in young breast cancer patients: when, what and for how long?
Christinat A, Di Lascio S, Pagani O.
Source
Institute of Oncology of Southern Switzerland (IOSI) and Breast Unit of Southern Switzerland (CSSI), Bellinzona, Switzerland.
Abstract
Breast cancer in young women (<40 years) is a rare and complex clinical and psychosocial condition, which deserves multidisciplinary and personalized approaches. In young women with hormone-receptor positive disease, 5 years of adjuvant tamoxifen, with or without ovarian suppression/ablation, is considered the standard endocrine therapy. The definitive role of adjuvant aromatase inhibitors has still to be elucidated: the upcoming results of the Tamoxifen and EXemestane Trial (TEXT) and Suppression of Ovarian Function Trial (SOFT) trials will help understanding if we can widen our current endocrine therapeutic options. The optimal duration of adjuvant endocrine therapy in young women also remains an unresolved issue. The recently reported results of the ATLAS and aTToM trials represent the first evidence of a beneficial effect of extended endocrine therapy in premenopausal women and provide an important opportunity in high-risk young patients. In the metastatic setting, endocrine therapy should be the preferred choice for endocrine responsive disease, unless there is evidence of endocrine resistance or need for rapid disease and/or symptom control. Tamoxifen in combination with ovarian suppression/ablation remains the 1st-line endocrine therapy of choice. Aromatase inhibitors in combination with ovarian suppression/ablation can be considered after progression on tamoxifen and ovarian suppression/ablation. Fulvestrant has not yet been studied in pre-menopausal women. Specific age-related treatment side effects (i.e., menopausal symptoms, change in body image and weight gain, cognitive function impairment, fertility damage/preservation, long-term organ dysfunction, sexuality) and the social impact of diagnosis and treatment (i.e., job discrimination, family management) should be carefully addressed when planning long-lasting endocrine therapies in young women with hormone-receptor positive early and advanced breast cancer.
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe

Last edited by Jackie07; 07-22-2013 at 05:50 AM..
Jackie07 is offline   Reply With Quote
Old 07-22-2013, 11:57 AM   #7
Hopeful
Senior Member
 
Join Date: Aug 2006
Posts: 3,380
Re: Quick question

Here is a link to a thread in the Articles Forum that I posted last year: http://her2support.org/vbulletin/sho...eferrerid=1173

Hopeful
Hopeful is offline   Reply With Quote
Old 07-22-2013, 03:31 PM   #8
Becky
Senior Member
 
Becky's Avatar
 
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
Re: Quick question

The study is ongoing. I have a friend in it and she is 8 years in on the Arimidex arm.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
Becky is offline   Reply With Quote
Old 07-22-2013, 06:11 PM   #9
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Quick question

Anastrozole Reduces Recurrence in Early Breast Cancer: 10-Year Results of the ATAC Trial

Summary

Anastrozole (Arimidex®) is better than tamoxifen (Nolvadex®) at preventing a recurrence of breast cancer in postmenopausal women with early-stage hormone receptor-positive tumors, according to 10-year follow-up results from ATAC, a large international clinical trial. However, it does not improve overall survival compared with tamoxifen.
Source

The Lancet Oncology, November 17, 2010 (see the journal abstract).
Background

Postmenopausal women who have been treated for early breast cancer and whose tumors are hormone receptor positive (that is, their tumors grow in response to the hormone estrogen) have been advised to take 5 years of adjuvant treatment with hormone therapy. For years the standard option was the antiestrogen drug tamoxifen. Tamoxifen treatment had been shown to help prevent a relapse and was considered the standard of care for this group of patients.
However, tamoxifen increases the risk of endometrial cancer and blood clotting disorders. It has been suggested that drugs called aromatase inhibitors (AIs), which are a different type of antiestrogen, might be a better alternative.
Like tamoxifen, AIs interfere with cancer cells’ use of hormones. But whereas tamoxifen interferes directly with the cancer cells’ ability to use estrogen to fuel growth, AIs block the action of an enzyme called aromatase, which helps the body to produce estrogen. Another difference is that tamoxifen can be used by both premenopausal and postmenopausal women, whereas AIs block estrogen production only in postmenopausal women.
The Study

The Arimidex, Tamoxifen Alone or in Combination (ATAC) study was a double-blinded phase III clinical trial that was designed to compare the ability of the AI anastrozole, tamoxifen, and the two drugs in combination to prevent breast cancer recurrence in postmenopausal women with hormone receptor-positive tumors.
The study enrolled 9,366 postmenopausal women with localized breast cancer (that is, cancer that hadn’t spread, or metastasized). The women were randomly assigned to receive 5 years of adjuvant treatment with anastrozole alone, tamoxifen alone, or a combination of the two. (The combination treatment group was subsequently discontinued because outcomes for patients in this group were essentially the same as those in the group receiving tamoxifen alone.) Most of the participants (84 percent) had hormone receptor-positive disease.
Results after a median follow-up of 68 months (5.7 years), published in 2005 (see the journal abstract), showed that, compared with tamoxifen, anastrozole prolonged disease-free survival by 13 percent, increased time to relapse by 21 percent, reduced the occurrence of cancer spreading to other organs (distant metastases) by 14 percent, and reduced the occurrence of cancer in the other breast by more than 40 percent. The differences were even greater when the analysis was restricted to women with hormone receptor-positive cancer.
In addition, anastrozole was associated with fewer serious side effects (endometrial cancer, blood clots, vaginal bleeding, and hot flashes) than tamoxifen, although bone fractures and joint pain were more common among patients in the anastrozole group. However, overall survival was similar in the two groups.
In 2006, researchers with the ATAC trial reported data showing that anastrozole was better tolerated than tamoxifen and resulted in fewer serious complications (see the journal abstract). Furthermore, anastrozole had a more favorable overall risk–benefit profile than tamoxifen, and women taking anastrozole had a lower recurrence rate than those taking tamoxifen.
Mainly on the basis of the results published in 2005, treatment with an AI became the standard adjuvant therapy for hormone receptor-positive breast cancer, although tamoxifen is still considered a reasonable alternative. Other trials, involving a total of more than 30,000 women, confirmed that treatment with an AI alone or after tamoxifen was beneficial for patients with hormone-sensitive breast cancer.
The current study reports findings after participants in ATAC had been followed for median of 10 years.
Results

This analysis continued to show a benefit of anastrozole compared with tamoxifen. Among women with hormone receptor-positive tumors, those randomly assigned to receive treatment with anastrozole had a 4.3 percent lower absolute rate of breast cancer recurrence after 10 years, and a 2.6 percent lower absolute rate of distant metastasis, than those randomly assigned to receive treatment with tamoxifen.
The differences between anastrozole and tamoxifen in time to relapse, cancer in the other breast, and disease-free survival were greatest in the first two years of treatment but were maintained throughout the follow-up period, including the period after treatment was completed. However, the authors found that this so-called “carryover effect” – in which benefits extend beyond the treatment period – began to wane after about 8 years.
During treatment, women in the anastrozole group had fewer serious adverse events related to treatment than women in the tamoxifen group. After treatment was completed, however, rates of serious adverse events evened out between the two groups. Patients taking anastrozole reported more fractures during treatment than those taking tamoxifen, but after the completion of treatment fracture rates again became similar in both groups.
Patients taking tamoxifen had higher rates of endometrial cancer and melanoma than those taking anastrozole. There was a slight trend toward more colorectal and lung cancers in patients taking anastrozole compared with those taking tamoxifen. Overall, however, cancers other than breast cancer occurred at similar rates in both groups.
The number of patient deaths, with or without breast cancer recurrence, was similar in the two groups after 10 years of follow-up. Thus, treatment with anastrozole did not improve overall survival compared with tamoxifen.
Comments

In an accompanying editorial, Michael Gnant, M.D., of the Medical University of Vienna in Austria, wrote that he is encouraged by the finding that “the benefit of 5 years’ treatment with anastrozole persists and even seems to increase over time. This so-called carryover effect gives reason for hope because it essentially means that we can intervene early in the course of the disease and affect the rate of recurrence and overall survival.”
It is reassuring, Dr. Gnant added, that “the clinically most important side-effect of aromatase inhibition – an increase in fractures because of reduced serum [estrogen] concentrations – subsides soon after intake of the active drug is stopped.”
Jo Anne Zujewski, M.D., of the National Cancer Institute’s Cancer Therapy Evaluation Program, said: “The 10-year results from ATAC provide strong evidence that anastrozole is both safe and effective in the treatment of postmenopausal women with early-stage breast cancer.”
Dr. Zujewski added, however, that “whether an individual patient should start therapy with an AI or begin therapy with tamoxifen and then change to an AI remains a subject of medical judgment and clinical research. Patients should talk with their doctors about which drug would be best for them given their particular medical condition.”
In August 2010, an ASCO expert committee released an updated Clinical Practice Guideline that recommends that postmenopausal women with hormone receptor-positive breast cancer consider using an AI during adjuvant treatment, either initially or after a course of adjuvant tamoxifen. The committee noted, however, that patients and their physicians should carefully consider side effect profiles when deciding on whether and when to use AI therapy.


http://www.cancer.gov/clinicaltrials.../2004/atac1204
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
'lizbeth is offline   Reply With Quote
Old 07-22-2013, 06:53 PM   #10
Becky
Senior Member
 
Becky's Avatar
 
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
Re: Quick question

This is just the results of the trial of Arimidex versus Tamoxifen after 10 years and how the stats hold up. Women on this trial were given 5 years of tamoxifen or 5 years of Arimidex and the AI was better. And the AI was better at these women's ten year mark. But nobody was on an AI ten years. That trial, using all three AIs (Arimidex, Femara and Aromosin) is still ongoing. There are no results yet because the ten year mark isn't here yet.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
Becky is offline   Reply With Quote
Old 07-23-2013, 01:32 PM   #11
tricia keegan
Senior Member
 
tricia keegan's Avatar
 
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Re: Quick question

Thank you so much everyone and sorry I didn't reply sooner but I've had computer problems for a couple of weeks and just had it repaired.

Thanks Jackie for the links and Becky for the info, I had suspected as much but wasn't sure but will be taking Arimidex for a further three years up to ten.

Thanks also Sandra and I hope it won't be too long before they find something to help hormone negs like yourself too!
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
tricia keegan is offline   Reply With Quote
Old 07-23-2013, 09:07 PM   #12
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Quick question

This is what the National Cancer Institute at the NIH is reporting. They do make it sound like the trial is finishing. But this isn't the first time I've heard of NIH doing some premature reporting. I remember reading about Peptide T and that it actually reduced viral loads in AIDs patients, but NIH didn't wait for those results and published a report that squelched the funding.

In the body of the article it does mention that the follow up data was just a little over 5 years, so perhaps they think we recognize it is an interim report.

Becky, since your are familiar with the trial, I hope you will let us know when the final data is available.

Thanks!
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease

Last edited by 'lizbeth; 07-24-2013 at 07:38 AM.. Reason: addition
'lizbeth is offline   Reply With Quote
Old 07-24-2013, 07:40 AM   #13
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Quick question




http://her2support.org/vbulletin/sho...145#post297145


ATAC trial: reporting interim results is not helpful

Heather Goodare, chairBreast UK (Breast-cancer Research Ethics and Advocacy Strategy), Horsham, West Sussex RH13 6DF ; Email: hm.goodare@virgin.net




Clare Dimmer, secretaryBreast UK Waterlooville, Hants PO7 6LA ; Email: clare@solvatec.demon.uk




Kathy Page, treasurer

Author information ► Copyright and License information ►

This article has been cited by other articles in PMC.


Editor—We should like to raise some concerns about the ATAC (arimidex, tamoxifen alone or in combination) trial, which was reported on in the Lancet after only half the time stipulated in the protocol (2.5 years instead of 5).1 Ravdin has raised important points: “Early reporting rules can powerfully affect what information can be gleaned from a trial, particularly if they cause a trial to be reported when many of the patients have not completed therapy.”2 In spite of this, the “results” of the trial were reported in the United Kingdom's national lay press.3
However, is arimidex really the best bet? Of course we still don't know as some of the more serious adverse events may not emerge until the five year mark is reached. The problems in patients with endometrial cancer who were taking tamoxifen took many years to become obvious. Why publish results at the halfway mark only? Does this not indicate a lack of respect for the participants?4
Early reporting of the trial was certainly good for AstraZeneca, after losing patent protection for tamoxifen. But was it good for patients? Was it good for science? Publication of interim results can seriously mislead, as in the case of the infamous study of women attending the Bristol Cancer Help Centre.5 As Ravdin says: “It remains to be seen how many of the patients on the two remaining blinded arms will continue to take the therapy that they were randomised to.”

Go to:
References

1. ATAC (Arimidex, Tamoxifen Alone or in Combination) Trialists' Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 2002;359: 2131-9. [PubMed]
2. Ravdin P. Aromatase inhibitors for the endocrine adjuvant treatment of breast cancer [commentary]. Lancet 2002;359: 2126. [PubMed]
3. Derbyshire D. New drug prevents breast cancer. Telegraph 2002. June 21.
4. MP. Case study: I was an ATAC guinea pig. What Doctors Don't Tell You 2003;13: 8.
5. Bagenal FS, Easton DF, Harris E, Chilvers CED, McElwain TJ. Survival of patients with breast cancer attending Bristol Cancer Help Centre. Lancet 1990;336: 606-10. [PubMed]
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
'lizbeth is offline   Reply With Quote
Old 07-24-2013, 11:10 AM   #14
tricia keegan
Senior Member
 
tricia keegan's Avatar
 
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Re: Quick question

Thanks 'Lizbeth and I recall reading this after the five year study was up I think, I've been taking it for seven years now and have agreed to another three so it'll be interesting when the final study results are released in two years approx.
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
tricia keegan is offline   Reply With Quote
Old 07-24-2013, 04:53 PM   #15
jaykay
Senior Member
 
Join Date: Oct 2012
Posts: 645
Re: Quick question

When I finished my five years of femara in January, 2010 (after 4.5 of tamoxifen), my onc asked if I wanted to stay on femara longer. I asked if there were any studies showing benefits of staying on AI's more than 5 years and she said that study was still in progress

That syncs with Becky's input re: 8 years. Of course, I get to go back on AI's for who knows how long again :-(
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
jaykay is offline   Reply With Quote
Old 08-04-2013, 04:20 AM   #16
Jackie07
Senior Member
 
Jackie07's Avatar
 
Join Date: Jan 2008
Location: "Love never fails."
Posts: 5,808
Re: Quick question - ASCO updates Guidelines on drugs

Just received this new update from CancerConnect:

ASCO Updates Guidelines on Interventions for Women at Increased Risk of Breast Cancer

The American Society of Clinical Oncology (ASCO) has released updated guidelines for pharmacologic interventions among women at an increased risk of breast cancer.

This third update of the guidelines, published in the Journal of Clinical Oncology, includes the addition of Aromasin® (exemestane) for the prevention of breast cancer in postmenopausal women at risk for estrogen receptor (ER)-positive disease. Women with a strong family history of breast cancer and women who carry the BRCA1 and BRCA2 genes are at an increased risk of developing breast cancer and may opt to take more aggressive preventive measures, including the use of “chemoprevention”, or drugs that block the effects of estrogen—because estrogen causes some cancers to grow.

There are two types of drugs used to block estrogen. Selective estrogen receptor modulators (SERMs) are drugs that block estrogen receptors within the breast cells, thereby reducing estrogen-stimulated growth. Tamoxifen and Evista® (raloxifene) are examples of SERMs. Aromatase inhibitors suppress the production of estrogen in postmenopausal women. Aromasin is an aromatase inhibitor. Each of these drugs has been shown to reduce the risk of breast cancer in women at high risk of the disease.

The updated recommendation guidelines from ASCO are as follows: For premenopausal women: The use of tamoxifen (20 mg per day orally for 5 years) should be discussed as an option to reduce the risk of invasive, estrogen receptor (ER)-positive breast cancer For postmenopausal women, there are now three options. ASCO strongly recommends that one of the following be considered in order to reduce the risk of invasive, estrogen receptor (ER)-positive breast cancer: Tamoxifen (20 mg per day orally for 5 years) Evista (60 mg per day orally for 5 years) Aromasin (25 mg per day orally for 5 years). (Note: This is a new recommendation, which was based on data from a clinical trial that showed up to a 70 percent reduction in overall and ER-positive invasive breast cancer incidence compared to placebo.)

What’s more, the recommendations state that all three agents should be discussed with women aged 35 or older without a personal history of breast cancer who are at increased risk of developing invasive breast cancer, based on risk factors such as age, race, and medical and reproductive history. Not all women will benefit from the use of these preventive agents. It is important that doctors and women discuss the risks and benefits of each drug in order to determine the best approach.

That said, only a small percentage of eligible women have this discussion with their doctors or even consider these medications. As such, the guidelines also stress the need for ongoing research to determine approaches to increase the use of these drugs in women who will benefit from them.

Reference: Visvanathan K, Hurley P, Bantug E, et al. Use of pharmacologic interventions for breast cancer risk reduction: American Society of Clinical Oncology Clinical Practice Guideline. Journal of Clinical Oncology. Published early online July 8, 2013. doi: 10.1200/JCO.2013.49.3122
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe

Last edited by Jackie07; 08-04-2013 at 04:25 AM..
Jackie07 is offline   Reply With Quote
Old 08-04-2013, 07:58 AM   #17
'lizbeth
Senior Member
 
'lizbeth's Avatar
 
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
Re: Quick question

Wow. There seems to be quite a shift in how the medical industry is treating cancer, especially in the last week.

It feels really exciting to me that women can actively have more tools to prevent cancer.

Progress!!!! Yeah!

Wouldn't it be amazing if someday we could all just have a vaccine shot once a year to prevent cancer based on our genetics and risk factors?
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
'lizbeth is offline   Reply With Quote
Old 08-05-2013, 04:54 PM   #18
tricia keegan
Senior Member
 
tricia keegan's Avatar
 
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Re: Quick question

Thank you for the latest info Jackie!
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
tricia keegan is offline   Reply With Quote
Old 08-05-2013, 05:00 PM   #19
Becky
Senior Member
 
Becky's Avatar
 
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
Re: Quick question

Saw my onc on Friday for a normal follow up and he said that they are starting a new trial where they will use some women in the current AI study of is 10 years better than 5 years and these 10 year women (at least some of them) will continue to 15 years and see if 15 years is better than 10.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
Becky is offline   Reply With Quote
Old 08-05-2013, 07:05 PM   #20
tricia keegan
Senior Member
 
tricia keegan's Avatar
 
Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Re: Quick question

Thanks Becky, I'm guessing we'll be taking this for life!!!
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
tricia keegan is offline   Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -7. The time now is 05:41 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2024, vBulletin Solutions, Inc.
Copyright HER2 Support Group 2007 - 2021
free webpage hit counter