Femara failing. Can I try eexemestane

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Punam
Punam Member Posts: 8
edited August 2018 in Stage IV/Metastatic Breast Cancer ONLY

I was diagnosed Stage IV with extensive bone mets from the start itself in end April 2016. I started Femara alongwith Zoladex and Xgeva in May 2016, which I was tolerating it quite well but now there is progression. My doctor suggests Ribociclib with Faslodex as the second line of treatment. I was a bit reluctant looking at diiferent SE. Anither option was to switch to exemestane or Tamoxifen but as per my onco there is only a 20% probability that it would work. Another option is to wait for 3 months and have a scan again. But then there is a 5% to 10% risk of fracture as per the doc. The mets in last two years have decreased a lot and not too big to go in for radiations. My doc will go as per my decision but I am in a fix and need the opinion of you experts. My questions are:

1) Should I try exemestane instead of Femara hoping it would further work.

2) Should I wait for 3 months for next scan

3) If I have to change treatment should I go in for Ribociclib or Palbociclib. Abemaciclib is not available in India and Ribociclib is cheaper.

I am really looking forward to these answers. Thanks a lot in anticipation.

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  • susan_02143
    susan_02143 Member Posts: 7,209
    edited August 2018

    From what I have read, Exemestane and Femara work quite differently and after one has failed you, the other can give you good results. Exemestane is also paired with Faslodex. This combination kept me at NED for five years, so it is certainly another option. In my case, we did the exemestane as a mono-treatment, and then added the faslodex later.

    Good luck making such a big decision.

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  • Punam
    Punam Member Posts: 8
    edited August 2018

    Thanks a lot Susan. Do you have any advice if Ribociclib is better or Palbociclib in terms of toxicity or effectivenes.

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  • JoE777
    JoE777 Member Posts: 628
    edited August 2018

    I'm having good success on ribociclib and femara. Don't know if other AIs are paired with ribociclib. All of my mets in sacrum significantly reduced and two out five nodules in lungsresolved other three are significantly reduced. No new mets since March. Hugs and Peace. Jo

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  • pajim
    pajim Member Posts: 2,785
    edited August 2018

    As I understand it ribo and palbo have the same mechanism of action and side-effect profile. They really are me-too drugs. Abemaciclib is different.

    If your progression is really small, you can wait three months. I waited almost a year -- scanned every three months. But if you have fast-growing cancer maybe not. You would know better.

    Another option is to try adding palbo to what you have now. I did that too and it made the other treatment last another year. So you could take Femara with ribociclib and scan in three months. Once that fails try Faslodex.

    Making these decisions is hard. Do remember that there is no right answer. You can pick one of your options now and another one when the first one fails. They'll all still be there later.

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