Lines of Endocrine Therapy

eleanora

I am very interested in the details of endocrine treatment experienced by other members with an ER+/HER2- diagnosis like mine but have been frustrated by trying to make sense of the info that appears beneath an individual's post. I am particularly interested in the chronological order of each type of treatment and whether you repeated a treatment (or variation of a treatment) at any point.

I hope that this will provide all of us with an easy reference on endocrine treatments.

If you would like to participate, please provide the following info in chronological order for each of your endocrine therapies:

NAME OF TREATMENT

DATES OF TREATMENT

REASON FOR STOPPING TREATMENT

ANY OTHER DETAILS YOU WOULD LIKE TO ADD

Thanks,

Eleanora

divinemrsm

My signature line is accurate but here are the details:

In early 2011, I was diagnosed stage iv bc from the start, invasive lobular carcinoma, her2-, mets to the bone: hip, rib, scapula.

I had neoadjuvant chemo: taxotere and cytoxan. Also the bone strengthener zometa.

After a lumpectomy and 33 rounds of radiation, I started the aromatase inhibitor Arimidex (anastrozole) in November 2011. This kept me stable for the next eight years.

Then I had progression to the bone so I went on ibrance (which wasn't on the market when I was initially diagnosed) and a different AI, Aromasin. This failed me miserably. Lots of progression and I stopped after less than six months.

I went on Verzenio by itself for the next six months and it, too failed. Ibrance and Verzenio were extremely hard on me physically.

In early 2020, I started the oral chemo Xeloda. It has kept things stable so far altho I have scans later this month and am having some issues now so not sure what the results will be. Overall, Xeloda has been a tolerable treatment.

So far the mets are confined to the bones. I continue getting zometa every three months. I will mark 12 years living with mbc in December.

star2017

After surgery/chemo I started tamoxifen (I was age 38, stage 3 at the time)

Then after I had my ovaries removed and had recovered from treatments and surgeries (about a year later), I was switched to anastrazole.

I was on that for about 2 years when we discovered bone metastasis (last year). After that I was on fulvestrant (+ Verzenio).

I took fulvestrant shots initially every two weeks and then once a month. About 6 months later, we discovered progression.

Since two lines of endocrine therapy failed, I am not on it now. I am only on Lynparza atm.

eleanora

Thanks divinemrsm and star2017 for starting us off and to divinemrsm for encouraging others to participate.

Here is my treatment:

diagnosed in 2019 er+/pr-/her2-

anastrazole from January 2020 to May 2022 - stopped because of progression to bone mets

fulvestrant from May 2022 to the present, with Kisqali added in August 2022. Start of Kisqali delayed to allow for radiation of bone mets.

exbrnxgrl

My signature line is pretty bare bones and I have run out of patience to try to fix it 😞.

Since the fall of 2011, I have been on one of the AI’s or another. I’m sorry that I no longer remember the dates. It’sbeen 11 years, but I have tried anastrozole, letrozole and am currently on Exemestane.

I kept switching in the hopes of finding one with fewer se’s. I have moderate joint pain in hands an knees and some bone pain as well as general stiffness if I don’t move around much. All effected me the same way. I take ibuprofen and use cannabis at night for pain relief. I should add that despite this I was able to work for 10 years after my dx. Even in retirement, I work as a substitute teacher for my former school district. I am working all of October in a 5th grade class.

I do not take any of the newer drugs such as Ibrance or Verzenio with my AI as is common nowadays. They were still in clinical trials when I was first dx’ed and since I have been NEAD for over a decade, my mo doesn’t see any reason to add them. Since radiation to my bone met, AI’s have been my only tx. Take care

nopink2019

I was able to delete all the crap that was in my diagnosis and just included it in my signature. I had no side effects on treatments for MBC except fatigue. Changed drugs due to progression in liver showing up on CT. Eribulin reduced my mets greatly, but I had neuropathy in feet & legs and major fatigue after 3 months. Took a month off & SE went away. So back on Eribulin at 10% lower dosage to see if it will reduce SE. Also might have another break after a few months as my blood work & tumor markers still looked good after taking the break.

exbrnxgrl

nopink,

Eribulin is not endocrine therapy, is it? I think the op is asking about endocrine therapy in particular not chemo

nopink2019

No, it isn't. Just explaining the progression my MO used after endocrine therapy.

bright55

Nopink2019 thankyou for your info

Your details clearly list the varied treatments and duration

My info should be listed as well...

Letrozole AI 2016 -19 2 1/2 years

Tamoxifen 2019 6 months

Everolomis targeted therapy plus exemestane AI 2019-2020 21/2 months pneumonitis

Kisquali Targeted therapy plus Faslodex AI 2020

Generally three types of antihormonal therapies are the norm before starting chemo

Dual therapies are now being offered as a first line therapy this is the major change from five years ago when they were not generally available

All the best

Bright in hope

eleanora

Thanks so much for posting Bright, exbrnxgrl and nopink.

nkb

I have been on AI for 5 years for IIIC--> progression to bone-->faslodex and Ibrance-->19 months--->progression in bones--> Afinitor and aromasin for 10 months---> progression in bones--> Xeloda x 2.5 years--->progression in bones--->Enhertu

I am considered endocrine resistant, although some believe that you can become sensitized again after a period off of them. I am hoping for a good oral SERD in the future- time will tell.

eleanora

NKB

Thanks for sharing a very clear summary of the path many are following.

Eleanora