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Topic: Interesting Re Extended Years of AI Tx in Post-Menopausal Women

Forum: Hormonal Therapy - Before, During, and After —

This is a safe place to share your experiences of others considering or on hormonal treatment.

Posted on: Sep 7, 2021 10:27AM - edited Sep 7, 2021 04:46PM by ThreeTree

ThreeTree wrote:

Came across this over the week-end and thought it was interesting and adds some possible new info to the mix. There seems to be a growing trend in urging women to continue AI's beyond 5 years. This provides food for thought against that argument, as it looks like for older women at least, the risk of heart problems may well go up after 4 years:

https://www.thebreastonline.com/article/S0960-9776(21)00412-4/fulltext#%252

Interesting that these researchers also believe that these AI's should be tested against a "clean" population that has not already been on some other sort of endocrine therapy. I'm no scientist and no medical researcher, but it has continued to baffle me as to why all of the research on AI's is compared to those on Tamoxifen, and then all of the research on Tamoxifen was compared to those on other drugs at the time. That has to have created all sorts of confounding factors and hence, unclear results. There are so many who voluntarily decline these treatments that it shouldn't be difficult to get around the ethical concern that is always noted with regard to why there is no straight head to head study of people on AI's vs no endocrine treatment at all.

These researchers do note limitations to their study of course, and this is just one study, not definitive, but I think it is illuminating and again underscores the need for finding an alternative to these estrogen deprivation treatments.

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Sep 7, 2021 01:07PM Olma61 wrote:

Interesting. So seemingly, I have not yet reached the danger zone for AI-related heart disease.

Menopause itself is a risk factor for heart disease though, so I agree it would make sense to compare AI users to the general population of similar age groups.

The drug ERSO is in development for ER+ breast cancer but still years away, if it even proves effective in human subjects

10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone
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Sep 7, 2021 02:29PM Hopeful82014 wrote:

Three Tree -

I'm having trouble finding that article (I get an error code). Would you mind posting the title of the piece? Thanks a LOT!

Dx IDC
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Sep 7, 2021 02:37PM Hopeful82014 wrote:

Olma - re: ERSO, even if it does prove effective, as a newly approved drug (likely w/out biosimilars, etc.) the cost will probably be sky high and insurers would likely be slow to cover it, is my guess. Sadly, I find it hard to get excited about new drugs/therapies coming down the pipeline.

Dx IDC
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Sep 7, 2021 02:58PM Olma61 wrote:

Hopeful, I copy pasted that link into Google to access the article since clicking didnt work for me either, let's see if I can fix it here


https://www.thebreastonline.com/article/S0960-9776(21)00412-4/fulltext#%252

10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone
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Sep 7, 2021 04:44PM ThreeTree wrote:

Olma - Thanks so very much for your Google version. Looks like it works. I'll try and edit my original post with another copy and paste and see what happens. I had no idea it wasn't working.

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Sep 7, 2021 04:48PM ThreeTree wrote:

I tried an edit to my original post and I think it works now. Need to highlight and then "go to ..." the page.

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Sep 8, 2021 01:43PM Texgirl wrote:

I am 16 years post dx with stage 3 BC. After doing about a year on Tamoxifen and Arimidex ,I settled on Aromasin ( Exemestane ) . I was on it about 15 years.

My Houston doc graduated me to 10 years as that was the latest info out. After that it was my call and I finally pulled the plug on it in April '21 . I believe it became my security blanket as the years went by....I have adjusted well to being totally free . My achy legs no longer bother me and my husband loves me being less moody ! I'm a happy camper. I have lost 20 lbs but started a low carb diet just prior to this so I'm not sure if it was the cause !!

Good luck to each of you as like so many other things...it is a personal choice. I would say this if the first AI doesn't suit ,there are others to try . THey do not all act the same with everyone !

Letha

Dx 2/8/2005, ILC/IDC, Left, 6cm+, Stage IIIC, Grade 2, 22/22 nodes, ER+/PR+, HER2-
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Sep 8, 2021 03:39PM Hopeful82014 wrote:

Olma and ThreeTree, thanks for your help accessing the study. There's a lot of interesting material in there.

Letha, congratulations on doing so well! That's very impressive, all around.

Dx IDC
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Sep 8, 2021 04:20PM muska wrote:

The problem I have with such studies, is that they dump everyone who is not stage IV into the same bucket called “early stage breast cancer.” Then a headline gets published everywhere stating that X number of years on AI is enough, after X there’s more harm than good. That’s not an accurate picture because what’s true for stage 1a is not necessarily true for stage 3c. I haven’t come across any references to more detailed data analytics on this site or elsewhere, but I haven’t researched it enough

Dx at 54 Dx 5/9/2013, DCIS/IDC, Right, <1cm, Stage IIIA, Grade 3, 7/11 nodes, ER+/PR+, HER2- (FISH) Dx 6/13/2013, LCIS, Both breasts Surgery 6/13/2013 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 7/25/2013 AC + T (Taxol) Surgery 2/20/2014 Reconstruction (left); Reconstruction (right) Hormonal Therapy 3/12/2014 Arimidex (anastrozole) Radiation Therapy 3/23/2014 Breast, Lymph nodes, Bone
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Sep 8, 2021 05:16PM ThreeTree wrote:

muska - I agree about the big lumping of "early breast cancer" vs stage IV. Along with the idea that what applies to stage 1 doesn't necessarily apply to stage 2, etc. they also don't delineate anything about tumor size or other characteristics. I think "early breast cancer" is far too broad of a category to use to make definitive conclusions, but it seems to be an "industry standard".

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