Rethinking Tamoxifen: Is Longer-Duration Therapy Better?

Contrary to prior findings, 10 versus 5 years of treatment improved outcomes for patients with estrogen receptor–positive breast cancer.

The standard of care regarding the duration of adjuvant tamoxifen treatment for patients with estrogen-receptor (ER)–positive breast cancer was established at 5 years after a National Surgical Adjuvant Breast and Bowel Project (NSABP) study showed that disease-free survival was inferior with 10 years versus 5 years of therapy (N Engl J Med 1989;320:479). Despite that practice-changing NSABP data, the duration of tamoxifen therapy has remained an open question.

Now, investigators for the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial have evaluated outcomes for 6846 patients with early-stage, ER-positive breast cancer. All patients received tamoxifen for 5 years and then were randomized 1:1 to stop tamoxifen or continue receiving it…

Reviewing Author

William J. Gradishar, MD

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)