Dr. Tripathy on 10 Versus 5 Years of Adjuvant Tamoxifen

Debu Tripathy, MD, co-leader, Women's Cancer Program, University of Southern California Norris Comprehensive Cancer Center, discusses results from the ATLAS trial that compared 5 years of adjuvant tamoxifen to 10 in patients with estrogen receptor-positive early breast cancer.

In the trial, 6846 women who had received approximately 5 years of prior adjuvant tamoxifen were randomized to receive 5 additional years of tamoxifen or to stop treatment. There was a 2.8% reduction in mortality risk for continuing treatment with tamoxifen, Tripathy notes. Additionally, the rate of recurrence for those receiving tamoxifen for 10 years was 25% less compared to those receiving just 5 years of treatment.

Tripathy believes these results could change practice for premenopausal women who are still premenopausal after the first 5 years of tamoxifen. Additionally, he adds, if patients are not candidates for aromatase inhibitors, they are at high-risk, and they are tolerating tamoxifen well they should be offered 5 more years of treatment.

The risk of developing endometrial cancer was approximately 2% higher for those receiving 10 years of tamoxifen, Tripathy adds. However, he feels that this risk is outweighed by the benefits of the additional treatment.