Faslodex vs Letrozole

Following up on Faslodex post by caw15.

Why do oncs decide to switch from Letrozole to Faslodex? Is it because of side effects not as severe as Letrozole?

[nstonerocks]

I don’t have a precise answer. I think letrozole is first line drug. In my case, there was some progression, so doc switched me to faslodex. From what I’ve read the Ibrance/faslodex combo has proven pretty effective. So far it is in my case. And it does seem that the joint discomfort is less or nonexistent with faslodex. Hate the shots, love feeling better and improved scans.

[Wintervt in reply to nstonerocks]

Nancy,

How long did you take Letrozole?

xo Jade

[nstonerocks in reply to Wintervt]

Probably a little less than 3 years. First on letrozole alone, then Ibrance added. Had lots of joint discomfort on letrozole. Of course we all want longevity out of our treatment, but I feel so much better on faslodex Fingers crosses

[Julie2233]

In the UK, the NHS won't allow you to have faslodex before letrazole (it's a lot cheaper). I started with faslodex because I was in the private sector but had to return to the NHS and was moved onto letrazole.

On faslodex I had very few side effects, the month on letrazole was awful. I went back to the oncologist with a full page of side effects including joint and bone pain and depression.

I was allowed to have the faslodex again because I'd had the letrazole and couldn't tolerate it. If I'd stayed on the letrazole or changed brands I may have got used to it, but for me the faslodex allowed me to live normally.

Unfortunately the faslodex ibrance combination stopped working after 18 cycles and I'm now on afinitor and exemestane. I've just done my first month on the new drug and finding it hard going. I would really love to be back on the faslodex / ibrance combination. It doesn't work for everyone but it suited me completely.

[Hidden in reply to Julie2233]

Wow! That explains while everyone starts on Letrozole! I'm so sorry you couldn't continue on it!

[kearnan in reply to Hidden]

I was started on falsodex. I was told Ibrance and falsodex was the first line of treatment. At least here in NY.

[intlstar1]

In my case, my insurance company (Humana) denied Letrazol because it is far more expensive than Faslodex! I appealed that decision because studies showed that Letrazol was far more effective for my type of breast cancer (EP+ HER - ), but of course I lost out to the insurance company as they would rather put dollars in their pocket than care about the drug that will respond better to my cancer!

[kearnan in reply to intlstar1]

They will always deny the more expensive drug or treatment if they feel that a cheaper version can be just as effective. Falsodex works for me. Give it a try and then if it does not work, I would imagine they would have to approve you for the other drug. I have no issues with falsodex injections. It is like a small pinch to me and I am able to sit immediately. I do not use heating pads and the technician puts on a small bandage and there is nothing on the bandage when I take it off. Easiest part of this whole treatment for me.

[PJBinMI]

I was diagnosed with MBC in 2004 and the other women I met who had a hormone receptor positive MBC and were past menapause were all given either Letrozole or its close cousin Arimidex (both non-steroidal aromatase inhibitors) and then Faslodex when the first med failed. I got almost five years from Letrozole (Femara) and then over nine years with Faslodex. I am on Exemestane now and my new, young onc and the bc specialist almost retired second opinion onc that I have seen both agree that Tamoxifen will be next but that I likely still have years ahead of me. I did have side effects from Letrozole. Celebrex helps achy joints. Effexor helps hot flashes. Compounded testosterone cream helps vaginal dryness and atrophy (shrinkage). I think that having women oncs and gynocologists helps us with some of that. At least I've had women docs and I've found them very responsive to my concerns. My second opinion bc onc is a man and he is great, too. But in truth, it's easier for me to talk about vaginal and sexual issues with a woman doctor! lol.

[Hidden in reply to PJBinMI]

I so agree with you! All my physicians are women. I also feel it makes treatments a lot more personal.

[Stacey7]

I was switched from tamoxifen to letrazole because I am now post menopausal. I still get Faslodex injections as well as the lupron injection.

[Hidden in reply to Stacey7]

You get both Letrozole and Faslodex Stacey? Or do I misunderstand

[Stacey7 in reply to Hidden]

Yes, I was taking tamoxifen and getting Faslodex injections. My oncologist took me off of the tamoxifen, and added lupron and letrazole. I am still getting the Faslodex injections as well.

[Hidden in reply to Stacey7]

I wonder how many oncologist use both Letro and Faslodex, as it seems to have therapeutic benefits. I will keep this in mind for discussion with my oncologist if needed! Thanks for this information Stacey. I always thought it was one or the other!!

[Stacey7 in reply to Hidden]

I was surprised too and ask my oncologist about it to make sure he hadn’t overlooked it he reassured me it was intentional

[lynzer]

I’ve been on falsodex/ibrance combo for a little over 2 years. Along with lupron and xgeva injections. I’ve been doing remarkably well on these drugs with some side effects but minimal.

I wanted to switch to letrizol because I hate the injections but my one said if it’s working you may want to stick with it....decisions...

[Hidden in reply to lynzer]

So great that it works so well for you! So yes, why change, right?

[lynzer in reply to Hidden]

Right...it’s just the inconvenience and pain of the injection

[kearnan in reply to lynzer]

Are you very thin? I have a meaty butt LOL. True. I warm them up under my arms and I stand up against the door and she puts one in and then the next. It's more of a pinch and afterwards I am fine. She did mention that very skinny women scream bloody murder. The first time I have to have the injections (last year) I was a bit overwhelmed and felt odd pulling my pants down until the technician said "Finally, something I can work with." She made me laugh and said seriously, very thin women scream bloody murder when I have to do their shots. I am like hurry up (its usually the last thing at my cancer center visits) bc all I want to do is go home.

[kearnan in reply to lynzer]

It's once a month and a pinch. If it is working, why rock the boat?

[Kakoburr]

It usually depends on whether you are post menopausal. However, if you did not respond to hormone blockers after an initial diagnosis, they will put you on faslodex rather than letrozole, even if you are postmenopausal.

[Hidden in reply to Kakoburr]

Ah, that makes a lot of sense! Thanks!

[lynzer]

It was my first line of treatment after chemotherapy/radiation and tamoxifen be of how aggressive my cancer was spreading