Femara vs Arimidex

My sister's mother-in-law was recently dx'd with BC. Her docs are talking
to her about participating in an Aromatase Inhibitor

clinical trial, a "randomized multi- center phase IIIb open label

study letrozole vx. anastrozole in adjuvant treatment of

postmenopausal women w/ hormone receptor & node positive breast

cancer. It's sponsored by Novartis Pharmaceuticals, at Chattanooga

Oncology & Hematology Associates.

They assign patients randomly to either letrozole (Femera) or

Arimidex (Anastrozole) or a period of 5 years. They cover as costs.

The question I have is:

Is this appropriate for her? Age 79

Why not Tamoxifen?

Is either drug recognized as better? If so, would the main benefit to

her to participating be to get the drugs free? If that's the case,

she'd just choose the best drug for her, and pay for treatment rather

than participating in a study that's randomized.

Mark

Hi Mark.

Comments interspersed.

Mark wrote:
> My sister's mother-in-law was recently dx'd with BC. Her docs are talking
> to her about participating in an Aromatase Inhibitor
> clinical trial, a "randomized multi- center phase IIIb open label
> study letrozole vx. anastrozole in adjuvant treatment of
> postmenopausal women w/ hormone receptor & node positive breast
> cancer.
....
> The question I have is:
> Is this appropriate for her? Age 79
>
Yes

> Why not Tamoxifen?
>
Because Tamoxifen does not have as good reduction in the rate of
recurrence as aromatase inhibitors. It is primarily for the
pre-menopausal, for whom aromatase inhibitors do not work. It also has
the advantage (for them) of being cheap and having a long track record,
so the long term side effects are well known.

> Is either drug recognized as better?
>
Femara is newer, and is thought to have some advantages over the older
aromatase inhibitors like Arimidex (at least by its manufacturers, but
then they would, wouldn't they?). The whole point of this study is to
determine whether there are significant advantages in terms of
recurrence rate or side effects.

> If so, would the main benefit to
> her to participating be to get the drugs free? If that's the case,
> she'd just choose the best drug for her, and pay for treatment rather
> than participating in a study that's randomized.
>
There is no guaranteed benefit to *her* in either arm of the trial, in
the one she gets a drug which is well known and accepted as the standard
treatment for her condition. In the other she gets a drug which might
be a bit more effective, and might be a bit riskier. And of course the
balance is unknown, else we wouldn't do a trial. It's really the toss
of a coin, so yes, the only benefit to her is free drugs,and perhaps the
advantage of having someone else toss the coin.

On the other hand there is benefit to the community in her participating
in the trial, it helps to incrementally improve treatments for future
generations, and she can make this contribution at no cost to herself.


Tim

Thanks Tim, Sharon was on Femara for about four years. I shuld have
figured that MGH would have been ginving the newer drug.

BTW, Sharon continues to do well. Just taking Zeloda now. Main issues are
fatigue and memory loss (from brain rads). She's now almost 5 1/2 yrs out
from her recurrance as a stage IV patient...

Mark


"Tim Jackson" <tim@tim-jackson.co.uk> wrote in message
news:45fd4837$0$8735$ed2619ec@ptn-nntp-reader02.plus.net...
> Hi Mark.
>
> Comments interspersed.
>
> Mark wrote:
>> My sister's mother-in-law was recently dx'd with BC. Her docs are
>> talking to her about participating in an Aromatase Inhibitor
>> clinical trial, a "randomized multi- center phase IIIb open label
>> study letrozole vx. anastrozole in adjuvant treatment of
>> postmenopausal women w/ hormone receptor & node positive breast
>> cancer.
> ...
>> The question I have is:
>> Is this appropriate for her? Age 79
>>
> Yes
>
>> Why not Tamoxifen?
>>
> Because Tamoxifen does not have as good reduction in the rate of
> recurrence as aromatase inhibitors. It is primarily for the
> pre-menopausal, for whom aromatase inhibitors do not work. It also has
> the advantage (for them) of being cheap and having a long track record, so
> the long term side effects are well known.
>
>> Is either drug recognized as better?
> Femara is newer, and is thought to have some advantages over the older
> aromatase inhibitors like Arimidex (at least by its manufacturers, but
> then they would, wouldn't they?). The whole point of this study is to
> determine whether there are significant advantages in terms of recurrence
> rate or side effects.
>
>> If so, would the main benefit to
>> her to participating be to get the drugs free? If that's the case,
>> she'd just choose the best drug for her, and pay for treatment rather
>> than participating in a study that's randomized.
>>
> There is no guaranteed benefit to *her* in either arm of the trial, in the
> one she gets a drug which is well known and accepted as the standard
> treatment for her condition. In the other she gets a drug which might be
> a bit more effective, and might be a bit riskier. And of course the
> balance is unknown, else we wouldn't do a trial. It's really the toss of
> a coin, so yes, the only benefit to her is free drugs,and perhaps the
> advantage of having someone else toss the coin.
>
> On the other hand there is benefit to the community in her participating
> in the trial, it helps to incrementally improve treatments for future
> generations, and she can make this contribution at no cost to herself.
>
>
> Tim

Mark wrote:
> Thanks Tim, Sharon was on Femara for about four years. I shuld have
> figured that MGH would have been ginving the newer drug.
>
> BTW, Sharon continues to do well. Just taking Zeloda now. Main issues are
> fatigue and memory loss (from brain rads). She's now almost 5 1/2 yrs out
> from her recurrance as a stage IV patient...
>
> Mark
>

Doesn't time fly. My congratulations to Sharon. It's a small price to
pay for survival.


Tim

"Tim Jackson" <tim@tim-jackson.co.uk> wrote in message
news:45fd4837$0$8735$ed2619ec@ptn-nntp-reader02.plus.net...

>> If so, would the main benefit to
>> her to participating be to get the drugs free?
<snip>
>>
> There is no guaranteed benefit to *her* in either arm of the trial,
....<snip>
>
> On the other hand there is benefit to the community in her participating
> in the trial, it helps to incrementally improve treatments for future
> generations, and she can make this contribution at no cost to herself.

One more possible benefit: Several friends have participated in trials, and
they've found the care & follow-up is especially meticulous. Not that the
rest of us get bad treatment, but it seems like there's some additional
attention associated with trial participants.

Ann T.
Remove 'dontsendspam' from address to reply by email

Sounds like this is a win-win--both drugs work well for
postmenopausal--the goal is to find out if one is better than the
other.

On Mar 18, 7:57 am, "Mark" <cir...@comcast.net> wrote:
> My sister's mother-in-law was recently dx'd with BC. Her docs are talking
> to her about participating in an Aromatase Inhibitor
>
> clinical trial, a "randomized multi- center phase IIIb open label
>
> study letrozole vx. anastrozole in adjuvant treatment of
>
> postmenopausal women w/ hormone receptor & node positive breast
>
> cancer. It's sponsored by Novartis Pharmaceuticals, at Chattanooga
>
> Oncology & Hematology Associates.
>
> They assign patients randomly to either letrozole (Femera) or
>
> Arimidex (Anastrozole) or a period of 5 years. They cover as costs.
>
> The question I have is:
>
> Is this appropriate for her? Age 79
>
> Why not Tamoxifen?
>
> Is either drug recognized as better? If so, would the main benefit to
>
> her to participating be to get the drugs free? If that's the case,
>
> she'd just choose the best drug for her, and pay for treatment rather
>
> than participating in a study that's randomized.
>
> Mark

"A.P. Thorsen" <annthorsendontsendspam@yahoo.com> wrote in message
news:etkr4e$tq0$1@news.msu.edu...
>
> "Tim Jackson" <tim@tim-jackson.co.uk> wrote in message
> news:45fd4837$0$8735$ed2619ec@ptn-nntp-reader02.plus.net...
>
>>> If so, would the main benefit to
>>> her to participating be to get the drugs free?
> <snip>
>>>
>> There is no guaranteed benefit to *her* in either arm of the trial,
> ...<snip>
>>
>> On the other hand there is benefit to the community in her participating
>> in the trial, it helps to incrementally improve treatments for future
>> generations, and she can make this contribution at no cost to herself.
>
> One more possible benefit: Several friends have participated in trials,
> and they've found the care & follow-up is especially meticulous. Not
> that the rest of us get bad treatment, but it seems like there's some
> additional attention associated with trial participants.

Yes, my GP calls it 'Rolls Royce' treatment. I'm in my tenth year and still
having immediate attention paid to everything I say.

I think (in my case at least) it's a matter of money. Zeneca pays for
everything for me (and thousands of others worldwide) so I'm not a burden on
the taxpayer and the doctors don't have to take that into consideration.

Mary

this is sort of off topic but I have a question....it will seem stupid...I
have read about how arimidex and tamoxifen work, receptors and binding and
blah blah....so what I don't understand is...why aren't they prescribed to
halt growth of an existing early-stage cancer?
"Mark" <cirone@comcast.net> wrote in message
news:hqidnfvImNy4qmDYnZ2dnUVZ_sCinZ2d@comcast.com. ..
> My sister's mother-in-law was recently dx'd with BC. Her docs are
talking
> to her about participating in an Aromatase Inhibitor
>
> clinical trial, a "randomized multi- center phase IIIb open label
>
> study letrozole vx. anastrozole in adjuvant treatment of
>
> postmenopausal women w/ hormone receptor & node positive breast
>
> cancer. It's sponsored by Novartis Pharmaceuticals, at Chattanooga
>
> Oncology & Hematology Associates.
>
> They assign patients randomly to either letrozole (Femera) or
>
> Arimidex (Anastrozole) or a period of 5 years. They cover as costs.
>
> The question I have is:
>
> Is this appropriate for her? Age 79
>
> Why not Tamoxifen?
>
> Is either drug recognized as better? If so, would the main benefit to
>
> her to participating be to get the drugs free? If that's the case,
>
> she'd just choose the best drug for her, and pay for treatment rather
>
> than participating in a study that's randomized.
>
> Mark
>
>

"fortunata" <pacifist@gmail.com> wrote in message
news:0leTh.35918$VU4.5107@bgtnsc05-news.ops.worldnet.att.net...
> this is sort of off topic but I have a question....it will seem
> stupid...I have read about how arimidex and tamoxifen work, receptors and
> binding and blah blah....so what I don't understand is...why aren't they
> prescribed to halt growth of an existing early-stage cancer?
>
They are after treatment is completed in women with positive to estrogen.
They even give tamoxifen to high risk women without breast cancer. Alex

"fortunata" <pacifist@gmail.com> wrote in message
news:0leTh.35918$VU4.5107@bgtnsc05-news.ops.worldnet.att.net...
> this is sort of off topic but I have a question....it will seem
> stupid...I have read about how arimidex and tamoxifen work, receptors and
> binding and blah blah....so what I don't understand is...why aren't they
> prescribed to halt growth of an existing early-stage cancer?

None of these things, to the best of my knowledge, have been researched as
first-line treatments (alternatives to surgery). Methods that work to shut
down stray cancer cells won't necessarily work to shut down a whole tumor.
You use different tactics to knock down a linebacker vs. a mosquito!
Surgery is the first-line treatment of choice - get the big cluster of known
cancer cells out of there.

Ann T.
Remove 'dontsendspam' from address to reply by email