Aa
Tamoxifin vs.Aromatase Inhibitors !
I need to know if Tamoxifin can be given to a person who had a mastectumy. The person is 74 years old and had her overies and uterus removed at the gae of 56. The person can not take Femera anymore because of sever side effect of join and muscle pain. The surgery was done in January and the person took Femera and since a few weeks ago the medication was switched to "Aromestane" and still severe side effects. Can Tamoxifin be givend to this person? Please advice!
SueYoung55 is correct that tamoxifen is usually used in premenopausal women with hormone-receptor positve BC, who are then switched to an AI when they complete menopause. But you are also correct that it can also be used in post-menopausal women, esp. when they cannot tolerate an AI.
Here is a summary of the current recommendations of the American Society of Clinical Oncologists:
"To lengthen disease-free survival and lower risk for recurrence (i.e., locoregional or distant recurrence or contralateral breast cancer), postmenopausal women with hormone receptor–positive breast cancer should consider an AI, either as primary adjuvant therapy for 5 years or sequentially after 2 to 3 years of tamoxifen to yield a total of 5 years of adjuvant endocrine therapy. Women who discontinue initial AI therapy before 5 years should consider using tamoxifen to bring the total duration of adjuvant therapy to 5 years.
Women who have completed 5 years of adjuvant tamoxifen therapy can benefit from switching to an AI. This extended therapy should not exceed 5 additional years.
ASCO does not recommend using specific markers to choose optimal adjuvant therapy.
Because of drug interactions, caution is recommended when tamoxifen and CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, bupropion) are used concomitantly.
When advising women about adjuvant therapy, clinicians should consider the adverse effect profiles of tamoxifen (venous thromboembolism and endometrial cancer, polyps, and hyperplasia) and AIs (osteoporosis, fractures, and arthralgias). Switching from tamoxifen to an AI (or vice versa) might be appropriate if adverse effects become intolerable or precipitate nonadherence.
Clinically important differences have not been shown among currently marketed AIs. Postmenopausal patients who cannot tolerate a particular AI should consider switching to a different AI or to tamoxifen."
I hope this helps.
Best wishes,
bluebutterfly
Here is a summary of the current recommendations of the American Society of Clinical Oncologists:
"To lengthen disease-free survival and lower risk for recurrence (i.e., locoregional or distant recurrence or contralateral breast cancer), postmenopausal women with hormone receptor–positive breast cancer should consider an AI, either as primary adjuvant therapy for 5 years or sequentially after 2 to 3 years of tamoxifen to yield a total of 5 years of adjuvant endocrine therapy. Women who discontinue initial AI therapy before 5 years should consider using tamoxifen to bring the total duration of adjuvant therapy to 5 years.
Women who have completed 5 years of adjuvant tamoxifen therapy can benefit from switching to an AI. This extended therapy should not exceed 5 additional years.
ASCO does not recommend using specific markers to choose optimal adjuvant therapy.
Because of drug interactions, caution is recommended when tamoxifen and CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, bupropion) are used concomitantly.
When advising women about adjuvant therapy, clinicians should consider the adverse effect profiles of tamoxifen (venous thromboembolism and endometrial cancer, polyps, and hyperplasia) and AIs (osteoporosis, fractures, and arthralgias). Switching from tamoxifen to an AI (or vice versa) might be appropriate if adverse effects become intolerable or precipitate nonadherence.
Clinically important differences have not been shown among currently marketed AIs. Postmenopausal patients who cannot tolerate a particular AI should consider switching to a different AI or to tamoxifen."
I hope this helps.
Best wishes,
bluebutterfly
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