How common is OS+Tam or AI vs. Tam alone?

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orangeflower
orangeflower Member Posts: 146
edited May 2020 in Hormonal Therapy - Before, During, and After

Hi all. I don't know if anyone knows the answer to this, but I'm wondering if most premenopausal women are given just tamoxifen pills, or if it's more common now to give ovarian suppression plus either tamoxifen or an aromatase inhibitor. I have a low-risk cancer and was node negative, but I'm on OS+AI. My oncology physical therapist said that most of her premenopausal patients are just on tamoxifen alone.

Thanks to all.

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  • BCat40
    BCat40 Member Posts: 241
    edited May 2020

    There were recent studies that showed that OS + AI has a slightly better efficacy rate in reducing recurrences than Tamoxifen, so many MOs are moving to that standard for women who will accept/tolerate the treatment and don't have other medical contraindications for the AI drugs. If some patients are already on Tamox and are tolerating it, it's possible that the MOs just keep that treatment rather than rock the boat.

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited May 2020

    Yes - currently it seems like tamoxifen alone works best for premenopausal women with low clinical risk factors (equally effective protection, but lower chance of serious side effects and statistically better tolerance), while OS+AI works best for premenopausal women with high clinical risk factors.

    High clinical risk factors could be things like young age (premenopausal at 29 is very different than premenopausal at 49, for example), positive nodes or LVI, high grade, high Oncotype, BRCA mutation, etc.

    My understanding is that doctors are thinking that a lot of the apparent benefit of chemo in some high ER/PR cases (generally thought to be less responsive to chemo) is actually from chemo's common side effect of suppressing menstruation.

    My doctor considered me to have low clinical risk (39, grade 2, 1.8cm, Oncotype 11, high margins, etc) and strongly recommended tamoxifen over OS+AI for me. Only when I was having difficulty tolerating tamoxifen, she offered to try OS+AI. (I ended up on a different SERM - toremifene).

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