Aromatase inhibitor in clear cell

Hi I am family doc living with Clear cell Ovarian CA and love your posts!
I am optimally debunked and responded very well to Chemo my Ca-125 is 19 up from 11.
Since clear cell is likely from the uterus, if my tissue is Estrogen receptor positive...what do you think about a trial of an Aromatatse Ihibitor?  Which one?

Thank-you so much for your time and efforts...I know how busy you MUST be...this is truly good work!!!

jamie

[Annekathryn Goodman, M.D.]

Dear Jamie,
thank you.
I am always moved and inspired by the women and men who post here.

I am so glad you are doing well. What a scarey thing to go through.

You ask a great question.  I definitely support the testing of the tissue for hormone receptors estrogen and progesterone. It is good to know if adjuvant therapy could play a role.

I have to say, tamoxifen is my favorite drug. It seems much kinder than arimidex and I have seen more responses to it - but this is in ovarian cancer.  
For uterine cancer, most of the literature is on the use of progesterones for which there is a robust 20% complete response in recurrent disease.  There is not much information on using hormone manipulation in the adjuvant setting.

There is a small risk of blood clots as well.

I would suggest getting as much information about this tumor as possible. -such as ER PR receptors.

In addition consider sending the tumor for analysis of gene mutations. This is totally experimental but the current thinking is that future therapy will involve targeting gene pathways in cancer cells.

It is called SnapShot analysis. Paraffin tissue can be sent to a Clia approved lab
(http://www.cms.gov/clia/)

for analysis.It takes about 4-8 weeks to get results. (We have such a lab at MGH. I imagine there are labs associated with some of the academic medical centers in California)

if you pubmed SnapShot, you will see the current scientific literature on it.
here is one link

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683860/?tool=pmcentrez


In addition to this, even though this is sort of outside the box, you should consider genetic testing such as for BRCA because your cancer has a rare subtype.

best wishes

[Jamgar]

Thank-you so much Dr. Goodman for being brave and brainstorming outside the box a bit with us ladies.  Group hug!