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ATAC
About the Trial
The Arimidex, Tamoxifen, Alone or in Combination trial randomized 9,366 postmenopausal women with early breast cancer to anastrozole, tamoxifen, or the combination. Anastrozole alone improved disease free survival over tamoxifen, with longer time to recurrence and fewer contralateral cancers, while the combination added toxicity without benefit. The aromatase inhibitor caused less endometrial cancer and clots but more fractures and joint symptoms. ATAC triggered the shift from tamoxifen to aromatase inhibitors for postmenopausal estrogen receptor positive disease, completed by BIG 1-98 with letrozole and IES with exemestane. Ten year follow ups confirmed durable superiority of AI based strategies.
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