Crazy ? - why not both tam and an AI

Leydi

So, oncologists typically treat with multiple chemotherapy drugs in combination. Why are all the studies I'm finding only comparing no hormonal therapy, tamoxifen alone, AI alone, or tamoxifen and AI taken in sequence? Has anyone looked at taking them in combination? They are different drugs that work in different ways with mostly different SE.

MelissaDallas

If the AI works like it should there should be no estrogen for tamoxifen to keep from binding to the receptors

Leydi

You definitely make a good point, MelissaDallas, with "if" being the key word. We know that neither tamoxifen nor AIs are 100% effective.

GG27

One really good reason for not taking both is that they have a severe drug reaction to each other. When you start to take an AI, they tell you to make sure that you've not taken tamoxifen. No pharmacist should allow you to take both at the same time.

coraleliz

Adherence is a problem with both AIs & Tamoxifen. It's seldom a side effect free experience. I doubt they could find enough BC patients to participate in such a study(even if there were no drug interactions).

Leydi

Oh, wow, thanks GG27. I didn't consider possible drug interactions between the two but now that you pointed that out, I'm able to find information about it. Apparently tamoxifen significantly reduces the effectiveness of the AI.

labelle

I think I read about a study that showed there was no added benefit found by taking both together, only more side effects, so that mode of treatment as never adapted.

However, many people do take these drugs in sequence. I'm taking Tamoxifen but my oncologist has suggested I switch to an AI in a couple of years, when we are sure I've actually gone through menopause. I don't think it is uncommon for women to start w Tamoxifen and then be switched to an AI later if/when they become postmenopausal.