Hi Mark.

Comments interspersed.

...

Yes

Because Tamoxifen does not have as good reduction in the rate of
recurrence as aromatase inhibitors.  It is primarily for the
pre-menopausal, for whom aromatase inhibitors do not work.  It also has
the advantage (for them) of being cheap and having a long track record,
so the long term side effects are well known.

Femara is newer, and is thought to have some advantages over the older
aromatase inhibitors like Arimidex (at least by its manufacturers, but
then they would, wouldn't they?).  The whole point of this study is to
determine whether there are significant advantages in terms of
recurrence rate or side effects.

There is no guaranteed benefit to *her* in either arm of the trial, in
the one she gets a drug which is well known and accepted as the standard
treatment for her condition.  In the other she gets a drug which might
be a bit more effective, and might be a bit riskier.  And of course the
balance is unknown, else we wouldn't do a trial.  It's really the toss
of a coin, so yes, the only benefit to her is free drugs,and perhaps the
advantage of having someone else toss the coin.

On the other hand there is benefit to the community in her participating
in the trial, it helps to incrementally improve treatments for future
generations, and she can make this contribution at no cost to herself.

Tim

Sounds like this is a win-win--both drugs work well for
postmenopausal--the goal is to find out if one is better than the
other.

this is sort of off topic but I have a question....it will seem stupid...I
have read about how arimidex and tamoxifen work, receptors and binding and
blah blah....so what I don't understand is...why aren't they prescribed to
halt growth of an existing early-stage cancer?
 > My sister's mother-in-law was recently dx'd with BC.  Her docs are
talking
 > to her about participating in an Aromatase Inhibitor
 >
 > clinical trial, a "randomized multi- center phase IIIb open label
 >
 > study letrozole vx. anastrozole in adjuvant treatment of
 >
 > postmenopausal women w/ hormone receptor & node positive breast
 >
 > cancer. It's sponsored by Novartis Pharmaceuticals, at Chattanooga
 >
 > Oncology & Hematology Associates.
 >
 > They assign patients randomly to either letrozole (Femera) or
 >
 > Arimidex (Anastrozole) or a period of 5 years. They cover as costs.
 >
 > The question I have is:
 >
 > Is this appropriate for her? Age 79
 >
 > Why not Tamoxifen?
 >
 > Is either drug recognized as better? If so, would the main benefit to
 >
 > her to participating be to get the drugs free? If that's the case,
 >
 > she'd just choose the best drug for her, and pay for treatment rather
 >
 > than participating in a study that's randomized.
 >
 > Mark
 >
 >