Each year before the San Antonio Breast Cancer Symposium begins, there is always a buzz about what the big news will be. There is little doubt that in 2012 the findings that garnered the most attention were from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial, which showed that taking the hormone therapy tamoxifen for 10 years was more effective than taking it for five, the currently recommended treatment.

To understand why this was significant, we need go back to 1995. That's when the NSABP B-14 study, a U.S. trial comparing 10 years of tamoxifen to five years of the drug, was stopped early because the trial data suggested that not only was 10 years not better--it might even be worse. (More recurrences were seen among the women taking tamoxifen longer.) From that point on, there was no question, at least in the U.S., that tamoxifen should be taken for five years--and no longer.

Outside the U.S., however, questions remained. And in 1996, convinced that the issue was not settled, the Clinical Trial Service Unit (CTSU) at the University of Oxford launched ATLAS, an international trial that enrolled 6,846 women with ER-positive breast cancer who had already taken tamoxifen for five years.  

Dr. Richard Gray

To learn more about the ATLAS trial, BCT spoke with Dr. Richard Gray, the professor of medical statistics at the University of Oxford who presented the findings at San Antonio on behalf of the ATLAS group.