New Breast Cancer Drugs May Beat Tamoxifen
Cancer Group OK's Arimidex, Aromasin, Femara to Prevent Recurrence
Lower Recurrent Breast Cancer, Side Effect Risk continued...
"Any benefit of [post-surgery] breast cancer chemotherapy is a matter of risk reduction," Munster tells WebMD. "The higher a woman's risk, the more the benefit. First, we need to know if a patient needs chemotherapy. If a woman has a hormone-sensitive tumor, the choice becomes which treatment to use. So since the aromatase inhibitors seem better, most doctors would use them first."Are Arimidex, Aromasin, and Femara interchangeable? Nobody knows yet. It will be years before definitive information is available. Munster says doctors now have to make their decisions based on limited evidence.
"Based on the information that is out there, if a patient came to me to get started, I would use Arimidex," Munster says. "If the patient has been on tamoxifen for two to three years, I would use Aromasin. But if she were on tamoxifen for five years, I would switch her to Femara."
Some doctors, Buzdar says, think there may be a long-term benefit to starting with tamoxifen, then switching to one of the new breast cancer drugs. But he believes the new drugs offer a woman her best chance of remaining cancer-free after surgery.
"The most important thing breast cancer patients should ask their doctors is why they are on tamoxifen and not on aromatase inhibitors," Buzdar says.
But there still are very good reasons to start with tamoxifen, says Carl Kardinal, MD, director of clinical research at the Ochsner Clinic Foundation in New Orleans.
"Tamoxifen has been around for more than 30 years. We know the side effects. The newer aromatase drugs, we don't really know yet," Kardinal tells WebMD. "Another issue which is very important is the cost. Tamoxifen is now available as a generic drug, and costs in the range of $40-$45 a month. Aromatase inhibitors like Arimidex and Femara cost more than $200 a month."