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Femara vs. Arimidex?

Page last modified on: November 20, 2008
Question from Lee: What is the difference in the aromatase inhibitors? Why would one doctor choose Femara over Arimidex?
Answer —Generosa Grana, M.D., F.A.C.P.: A lot has been made about differences in chemical structure, differences in whether a compound is steroidal, such as Aromasin, or non-steroidal such as Femara. Much has been made about how much these compounds suppress estrogen production, and whether they block the enzyme in the reversible or irreversible fashion.

But the reality is that there is no direct clinical evidence demonstrating in a head-to-head comparison (a study that directly compares one drug to the other) that any one of these drugs is superior to any other. Most oncologists tend to select the aromatase inhibitor that has been studied in a particular setting. It may also be affected by whether those clinicians have been involved in some of those studies.

For example, in newly diagnosed breast cancer patients who are post-menopausal, people tend to choose either tamoxifen or Arimidex or Femara because Arimidex and Femara have been studied in post-menopausal women and shown to be better than tamoxifen and with a better safety profile. If a woman has been on tamoxifen for two to three years and she and her oncologist are considering switching, most would switch to either Aromasin or Arimidex because clinical trials with these two drugs did exactly that.

Women going on an aromatase inhibitor after five years of tamoxifen tend to be recommended Femara because the MA-17 trial did exactly that. So most people tend to be clinical trial based and use the results of clinical trials to make decisions in their practice. But there is no direct comparison between these three drugs.

On Wednesday, December 21, 2005, our Ask-the-Expert Online Conference was called Updates from San Antonio Breast Cancer Symposium 2005. Generosa Grana, M.D., F.A.C.P. and moderator Marisa Weiss, M.D. brought you the highlights of the 2005 Breast Cancer Symposium and answered your questions about the latest diagnostic and treatment options for breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Generosa Grana, M.D., F.A.C.PGenerosa Grana, M.D., F.A.C.P. is the director of the Cooper Cancer Institute and heads the division of hematology/medical oncology at Cooper University Hospital.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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