Timing of AIs
There has been much research and discussion about the optimal use/strategy of tamoxifen and any of the AIs. Is it better to start with tam and then, two or so years later, switch to an AI? Is it better to finish 5 years of tam and then switch? Etc, etc. etc. In my groups, there is always some consternation as women discover that almost everyone is on a slightly different schedule.
This reports from last week's San Antonio meeting suggests that the timing does not matter, that virtually any of the common strategies work equally well. As always, this is an "ask your doctor" question when you are considering your personal situation. Note that this is an abstract only, preliminary results. If you want to read more, there is a link at the end.
SAN ANTONIO -- Women get the same breast cancer outcomes long term whether they start out on exemestane (Aromasin) or switch to it after a few years on tamoxifen, researchers found.
• Note that the trial was associated with some short-term but no long-term differences in outcome between the two strategies.
• Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.
At five years, exemestane monotherapy yielded nearly identical disease-free survival as was achieved when the aromatase inhibitor was started after two-and-a-half to three years of tamoxifen (85.7% versus 85.4%, P=0.604), Daniel Rea, MD, of the University of Birmingham in England reported here at the San Antonio Breast Cancer Symposium.
Gone were the modestly better outcomes with exemestane seen at the 2.75-year analysis reported at the same meeting last year. These results from the TEAM (Tamoxifen Exemestane Adjuvant Multinational) trial revealed no trace of superiority for any secondary endpoint either, according to Rea and his colleagues.