The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment

S. Duffy; T. L. Jackson; M. Lansdown; K. Philips; M. Wells; S. Pollard; G. Clack; M. Coibion; A. R. Bianco; J. Adams; M. Baum; A. Buzdar; D. Cella; R. Coleman; M. Constenla; J. Cuzick; W. Distler; M. Dowset; R. Eastell; L. J. Fallowfield; J. Forbes; W. D. George; J. Gray; J. P. Guastalla; R. Hellmund; G. Hoctin-Boes; J. Houghton; N. Williams; A. Howell; J. G.M. Klijn; G. Y. Locker; J. Mackey; R. E. Mansel; J. M. Nabholtz; T. Naglkalnai; A. Nicolucci; U. Nylen; R. Sainsbury; F. Sapunar; V. J. Suarez-Mendez; J. S. Tobias; M. Friedlander; G. Richardson; A. Makar; P. Neven; Guastalla; J. Mention; D. W. Distler; W. Eiermann; M. Mouritis

doi:10.1093/humrep/dei322

The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment

S. Duffy^*, T. L. Jackson, M. Lansdown, K. Philips, M. Wells, S. Pollard, G. Clack, M. Coibion, A. R. Bianco, J. Adams, M. Baum, A. Buzdar, D. Cella, R. Coleman, M. Constenla, J. Cuzick, W. Distler, M. Dowset, R. Eastell, L. J. FallowfieldJ. Forbes, W. D. George, J. Gray, J. P. Guastalla, R. Hellmund, G. Hoctin-Boes, J. Houghton, N. Williams, A. Howell, J. G.M. Klijn, G. Y. Locker, J. Mackey, R. E. Mansel, J. M. Nabholtz, T. Naglkalnai, A. Nicolucci, U. Nylen, R. Sainsbury, F. Sapunar, V. J. Suarez-Mendez, J. S. Tobias, M. Friedlander, G. Richardson, A. Makar, P. Neven, Guastalla, J. Mention, D. W. Distler, W. Eiermann, M. Mouritis

^*Corresponding author for this work

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Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Tamoxifen treatment results in a doubling of the risk of endometrial cancer after 1-2 years of treatment and a quadrupling after 5 years. Anastrozole, a third-generation aromatase inhibitor, with superior efficacy to tamoxifen, may also offer tolerability benefits in terms of effects on the endometrium. Methods and results: A sub-protocol of the ATAC trial compared the incidence/type of intrauterine changes following treatment with these agents in a subgroup of patients (n = 285) from the main trial. After 2 years anastrozole treatment, endometrial thickness remained ≤ 5 mm (baseline: 3.0 mm); in patients receiving tamoxifen, endometrial thickness increased by 3.2 mm to 7.0 mm, with a similar trend in the combination group. At baseline, 26/285 patients (9.1%) had endometrial abnormalities, most commonly polyps. After 2 years the number of endometrial abnormalities appeared lower with anastrozole treatment compared with tamoxifen although these differences were not statistically significant (odds ratio: 0.44; 95% confidence interval 0.146, 1.314; P = 0.14). Most abnormalities occurred within the first year of treatment (anastrozole: 4/6; tamoxifen: 7/10; combination: 10/16; total: 21/32). Fewer patients in the anastrozole group (1.4%) required medical intervention (tamoxifen 12.5%; combination 13.6%). Conclusions: Fewer endometrial abnormalities occurred during 2 years treatment with anastrozole compared with tamoxifen although statistical significance was not reached in this sub-protocol analysis.

Original language	English (US)
Pages (from-to)	545-553
Number of pages	9
Journal	Human Reproduction
Volume	21
Issue number	2
DOIs	https://doi.org/10.1093/humrep/dei322
State	Published - Feb 1 2006

Funding

S.Duffy, A.R.Bianco and M.Coibion have all received travel awards from AstraZeneca to attend the ATAC trial steering committee meetings. T.Jackson has received funding from AstraZeneca to present data at several conferences. M.Lansdown has accepted funding from AstraZeneca to attend accredited postgraduate meetings and his department has received financial support for trials approved by the ethics committee. S.Pollard holds a contract with AstraZeneca for operational management and to support some of the monitoring of the trial. G.Clack is an employee of AstraZeneca.

Keywords

ATAC
Anastrozole
Breast cancer
Endometrial pathology
Tamoxifen

ASJC Scopus subject areas

Obstetrics and Gynecology
Reproductive Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/humrep/dei322

Cite this

Duffy, S., Jackson, T. L., Lansdown, M., Philips, K., Wells, M., Pollard, S., Clack, G., Coibion, M., Bianco, A. R., Adams, J., Baum, M., Buzdar, A., Cella, D., Coleman, R., Constenla, M., Cuzick, J., Distler, W., Dowset, M., Eastell, R., ... Mouritis, M. (2006). The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment. Human Reproduction, 21(2), 545-553. https://doi.org/10.1093/humrep/dei322

@article{fa1a35fcedae4cfe82886852b4209e97,

title = "The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment",

abstract = "Background: Tamoxifen treatment results in a doubling of the risk of endometrial cancer after 1-2 years of treatment and a quadrupling after 5 years. Anastrozole, a third-generation aromatase inhibitor, with superior efficacy to tamoxifen, may also offer tolerability benefits in terms of effects on the endometrium. Methods and results: A sub-protocol of the ATAC trial compared the incidence/type of intrauterine changes following treatment with these agents in a subgroup of patients (n = 285) from the main trial. After 2 years anastrozole treatment, endometrial thickness remained ≤ 5 mm (baseline: 3.0 mm); in patients receiving tamoxifen, endometrial thickness increased by 3.2 mm to 7.0 mm, with a similar trend in the combination group. At baseline, 26/285 patients (9.1%) had endometrial abnormalities, most commonly polyps. After 2 years the number of endometrial abnormalities appeared lower with anastrozole treatment compared with tamoxifen although these differences were not statistically significant (odds ratio: 0.44; 95% confidence interval 0.146, 1.314; P = 0.14). Most abnormalities occurred within the first year of treatment (anastrozole: 4/6; tamoxifen: 7/10; combination: 10/16; total: 21/32). Fewer patients in the anastrozole group (1.4%) required medical intervention (tamoxifen 12.5%; combination 13.6%). Conclusions: Fewer endometrial abnormalities occurred during 2 years treatment with anastrozole compared with tamoxifen although statistical significance was not reached in this sub-protocol analysis.",

keywords = "ATAC, Anastrozole, Breast cancer, Endometrial pathology, Tamoxifen",

author = "S. Duffy and Jackson, {T. L.} and M. Lansdown and K. Philips and M. Wells and S. Pollard and G. Clack and M. Coibion and Bianco, {A. R.} and J. Adams and M. Baum and A. Buzdar and D. Cella and R. Coleman and M. Constenla and J. Cuzick and W. Distler and M. Dowset and R. Eastell and Fallowfield, {L. J.} and J. Forbes and George, {W. D.} and J. Gray and Guastalla, {J. P.} and R. Hellmund and G. Hoctin-Boes and J. Houghton and N. Williams and A. Howell and Klijn, {J. G.M.} and Locker, {G. Y.} and J. Mackey and Mansel, {R. E.} and Nabholtz, {J. M.} and T. Naglkalnai and A. Nicolucci and U. Nylen and R. Sainsbury and F. Sapunar and Suarez-Mendez, {V. J.} and Tobias, {J. S.} and M. Friedlander and G. Richardson and A. Makar and P. Neven and Guastalla and J. Mention and Distler, {D. W.} and W. Eiermann and M. Mouritis",

note = "Funding Information: S.Duffy, A.R.Bianco and M.Coibion have all received travel awards from AstraZeneca to attend the ATAC trial steering committee meetings. T.Jackson has received funding from AstraZeneca to present data at several conferences. M.Lansdown has accepted funding from AstraZeneca to attend accredited postgraduate meetings and his department has received financial support for trials approved by the ethics committee. S.Pollard holds a contract with AstraZeneca for operational management and to support some of the monitoring of the trial. G.Clack is an employee of AstraZeneca.",

year = "2006",

month = feb,

day = "1",

doi = "10.1093/humrep/dei322",

language = "English (US)",

volume = "21",

pages = "545--553",

journal = "Human Reproduction",

issn = "0268-1161",

publisher = "Oxford University Press",

number = "2",

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Duffy, S, Jackson, TL, Lansdown, M, Philips, K, Wells, M, Pollard, S, Clack, G, Coibion, M, Bianco, AR, Adams, J, Baum, M, Buzdar, A, Cella, D, Coleman, R, Constenla, M, Cuzick, J, Distler, W, Dowset, M, Eastell, R, Fallowfield, LJ, Forbes, J, George, WD, Gray, J, Guastalla, JP, Hellmund, R, Hoctin-Boes, G, Houghton, J, Williams, N, Howell, A, Klijn, JGM, Locker, GY, Mackey, J, Mansel, RE, Nabholtz, JM, Naglkalnai, T, Nicolucci, A, Nylen, U, Sainsbury, R, Sapunar, F, Suarez-Mendez, VJ, Tobias, JS, Friedlander, M, Richardson, G, Makar, A, Neven, P, Guastalla, Mention, J, Distler, DW, Eiermann, W & Mouritis, M 2006, 'The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment', Human Reproduction, vol. 21, no. 2, pp. 545-553. https://doi.org/10.1093/humrep/dei322

TY - JOUR

T1 - The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial

T2 - First results of the endometrial sub-protocol following 2 years of treatment

AU - Duffy, S.

AU - Jackson, T. L.

AU - Lansdown, M.

AU - Philips, K.

AU - Wells, M.

AU - Pollard, S.

AU - Clack, G.

AU - Coibion, M.

AU - Bianco, A. R.

AU - Adams, J.

AU - Baum, M.

AU - Buzdar, A.

AU - Cella, D.

AU - Coleman, R.

AU - Constenla, M.

AU - Cuzick, J.

AU - Distler, W.

AU - Dowset, M.

AU - Eastell, R.

AU - Fallowfield, L. J.

AU - Forbes, J.

AU - George, W. D.

AU - Gray, J.

AU - Guastalla, J. P.

AU - Hellmund, R.

AU - Hoctin-Boes, G.

AU - Houghton, J.

AU - Williams, N.

AU - Howell, A.

AU - Klijn, J. G.M.

AU - Locker, G. Y.

AU - Mackey, J.

AU - Mansel, R. E.

AU - Nabholtz, J. M.

AU - Naglkalnai, T.

AU - Nicolucci, A.

AU - Nylen, U.

AU - Sainsbury, R.

AU - Sapunar, F.

AU - Suarez-Mendez, V. J.

AU - Tobias, J. S.

AU - Friedlander, M.

AU - Richardson, G.

AU - Makar, A.

AU - Neven, P.

AU - Guastalla,

AU - Mention, J.

AU - Distler, D. W.

AU - Eiermann, W.

AU - Mouritis, M.

N1 - Funding Information: S.Duffy, A.R.Bianco and M.Coibion have all received travel awards from AstraZeneca to attend the ATAC trial steering committee meetings. T.Jackson has received funding from AstraZeneca to present data at several conferences. M.Lansdown has accepted funding from AstraZeneca to attend accredited postgraduate meetings and his department has received financial support for trials approved by the ethics committee. S.Pollard holds a contract with AstraZeneca for operational management and to support some of the monitoring of the trial. G.Clack is an employee of AstraZeneca.

PY - 2006/2/1

Y1 - 2006/2/1

N2 - Background: Tamoxifen treatment results in a doubling of the risk of endometrial cancer after 1-2 years of treatment and a quadrupling after 5 years. Anastrozole, a third-generation aromatase inhibitor, with superior efficacy to tamoxifen, may also offer tolerability benefits in terms of effects on the endometrium. Methods and results: A sub-protocol of the ATAC trial compared the incidence/type of intrauterine changes following treatment with these agents in a subgroup of patients (n = 285) from the main trial. After 2 years anastrozole treatment, endometrial thickness remained ≤ 5 mm (baseline: 3.0 mm); in patients receiving tamoxifen, endometrial thickness increased by 3.2 mm to 7.0 mm, with a similar trend in the combination group. At baseline, 26/285 patients (9.1%) had endometrial abnormalities, most commonly polyps. After 2 years the number of endometrial abnormalities appeared lower with anastrozole treatment compared with tamoxifen although these differences were not statistically significant (odds ratio: 0.44; 95% confidence interval 0.146, 1.314; P = 0.14). Most abnormalities occurred within the first year of treatment (anastrozole: 4/6; tamoxifen: 7/10; combination: 10/16; total: 21/32). Fewer patients in the anastrozole group (1.4%) required medical intervention (tamoxifen 12.5%; combination 13.6%). Conclusions: Fewer endometrial abnormalities occurred during 2 years treatment with anastrozole compared with tamoxifen although statistical significance was not reached in this sub-protocol analysis.

AB - Background: Tamoxifen treatment results in a doubling of the risk of endometrial cancer after 1-2 years of treatment and a quadrupling after 5 years. Anastrozole, a third-generation aromatase inhibitor, with superior efficacy to tamoxifen, may also offer tolerability benefits in terms of effects on the endometrium. Methods and results: A sub-protocol of the ATAC trial compared the incidence/type of intrauterine changes following treatment with these agents in a subgroup of patients (n = 285) from the main trial. After 2 years anastrozole treatment, endometrial thickness remained ≤ 5 mm (baseline: 3.0 mm); in patients receiving tamoxifen, endometrial thickness increased by 3.2 mm to 7.0 mm, with a similar trend in the combination group. At baseline, 26/285 patients (9.1%) had endometrial abnormalities, most commonly polyps. After 2 years the number of endometrial abnormalities appeared lower with anastrozole treatment compared with tamoxifen although these differences were not statistically significant (odds ratio: 0.44; 95% confidence interval 0.146, 1.314; P = 0.14). Most abnormalities occurred within the first year of treatment (anastrozole: 4/6; tamoxifen: 7/10; combination: 10/16; total: 21/32). Fewer patients in the anastrozole group (1.4%) required medical intervention (tamoxifen 12.5%; combination 13.6%). Conclusions: Fewer endometrial abnormalities occurred during 2 years treatment with anastrozole compared with tamoxifen although statistical significance was not reached in this sub-protocol analysis.

KW - ATAC

KW - Anastrozole

KW - Breast cancer

KW - Endometrial pathology

KW - Tamoxifen

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UR - http://www.scopus.com/inward/citedby.url?scp=31544474866&partnerID=8YFLogxK

U2 - 10.1093/humrep/dei322

DO - 10.1093/humrep/dei322

M3 - Article

C2 - 16210385

AN - SCOPUS:31544474866

SN - 0268-1161

VL - 21

SP - 545

EP - 553

JO - Human Reproduction

JF - Human Reproduction

IS - 2

ER -

The ATAC ('Arimidex', tamoxifen, alone or in combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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