Question: Are there currently any clinical trials for premenopausal women/women diagnosed under 40 on the use of aromatase inhibitors vs. tamoxifen?

Dr. Knopf: Yes – there is a great clinical trial now called the SOFT trial (Suppression of Ovarian Function Trial).

(This link will let you find a center near you that offers it. If not step backwards through www.cancer.gov and search for the trial directly.)

Women on this trial will be randomized to either tamoxifen (50 percent chance) or ovarian suppression for 5 years with a medicine that tells the brain to “shut down” the ovaries called triptorelin, a GnRH agonist (50 percent).

Women whose ovaries have been suppressed will then be randomized a 2nd time between tamoxifen (50 percent chance) and aromasin (50 percent chance), an aromatase inhibitor.

Since in postmenopausal women aromatase inhibitors are superior to tamoxifen there is a hunch that the ovarian suppression/aromasin arm will be the best arm – we’ll have to see what the trial shows.