Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen

Mitch Dowsett, Jack Cuzick, Jim Ingle, Alan Coates, John Forbes, Judith Bliss, Marc Buyse, Michael Baum, Jon Godwin

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670 Citations (Scopus)


The purpose of this study was to conduct meta-analyses of randomized trials of aromatase inhibitors (AIs) compared with tamoxifen either as initial monotherapy (cohort 1) or after 2 to 3 years of tamoxifen (cohort 2). Data submitted to the Early Breast Cancer Trialists' Collaborative Group were used in separate meta-analyses of two cohorts. Primary analyses involve postmenopausal women with tumors reported to be estrogen receptor positive. Log-rank P values are two-sided. Cohort 1 comprised 9,856 patients with a mean of 5.8 years of follow-up. At 5 years, AI therapy was associated with an absolute 2.9% (SE = 0.7%) decrease in recurrence (9.6% for AI v 12.6% for tamoxifen; 2P <.00001) and a nonsignificant absolute 1.1% (SE = 0.5%) decrease in breast cancer mortality (4.8% for AI v 5.9% for tamoxifen; 2P = .1). Cohort 2 comprised 9,015 patients with a mean of 3.9 years of follow-up.

Original languageEnglish
Pages (from-to)509-518
Number of pages10
JournalJournal of Clinical Oncology
Issue number3
Publication statusPublished - 1 Jan 2010


  • breast cancer
  • tamoxifen
  • clinical trials
  • aromatase inhibitors


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