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Bending the Curve Trial by Trial
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EBCTCG

Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials

Phase meta-analysisN = 31,920

Population
Postmenopausal women with estrogen-receptor-positive early breast cancer (31,920 women)
Design
Meta-analysis of individual patient data from randomised trials comparing 5 years of aromatase inhibitor with 5 years of tamoxifen, 5 years of aromatase inhibitor with 2-3 years of tamoxifen then aromatase inhibitor, and the switching strategy with 5 years of tamoxifen; intention-to-treat log-rank analyses stratified by age, nodal status and trial
Arms
  • Aromatase inhibitor (experimental): Aromatase inhibitor strategies (5 years, or switch after 2-3 years of tamoxifen)
  • Tamoxifen (control): 5 years of tamoxifen
People
Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Early Breast Cancer Trialists' Collaborative Group
Breast cancer mortalityHR 0.85 (95% CI 0.75–0.96)Δ Breast cancer mortality−2.1 pointsAny first recurrenceHR 0.64 (95% CI 0.52–0.78)Any first recurrenceHR 0.80 (95% CI 0.68–0.93)Breast cancer mortalityHR 0.86 (95% CI 0.80–0.94)All-cause mortalityHR 0.88 (95% CI 0.82–0.94)
Show the numbers
Results reported for EBCTCG
EndpointAnalysisAromatase inhibitorTamoxifenEffect
Breast cancer mortality5 years of aromatase inhibitor vs 5 years of tamoxifen comparisonprimaryEarly 201512.1%14.2%HR 0.85 (95% CI 0.75–0.96)P=0.009Rate ratio (RR) from a log-rank analysis, not a hazard ratio. Percentages are 10-year breast cancer mortality.
Any first recurrence5 years of aromatase inhibitor vs 5 years of tamoxifen, years 0-1primaryEarly 2015——HR 0.64 (95% CI 0.52–0.78)Rate ratio, not a hazard ratio.
Any first recurrence5 years of aromatase inhibitor vs 5 years of tamoxifen, years 2-4primaryEarly 2015——HR 0.80 (95% CI 0.68–0.93)Rate ratio, not a hazard ratio.
Breast cancer mortalityAll three comparison types aggregatedprimaryEarly 2015——HR 0.86 (95% CI 0.80–0.94)P=0.0005Rate ratio, not a hazard ratio.
All-cause mortalityAll three comparison types aggregatedprimaryEarly 2015——HR 0.88 (95% CI 0.82–0.94)P=0.0003Rate ratio, not a hazard ratio.
Results reported for EBCTCG
EndpointAnalysisAromatase inhibitorTamoxifenEffect
Breast cancer mortality5 years of aromatase inhibitor vs 5 years of tamoxifen comparisonprimaryEarly 201512.1%14.2%HR 0.85 (95% CI 0.75–0.96)P=0.009Rate ratio (RR) from a log-rank analysis, not a hazard ratio. Percentages are 10-year breast cancer mortality.
Any first recurrence5 years of aromatase inhibitor vs 5 years of tamoxifen, years 0-1primaryEarly 2015——HR 0.64 (95% CI 0.52–0.78)Rate ratio, not a hazard ratio.
Any first recurrence5 years of aromatase inhibitor vs 5 years of tamoxifen, years 2-4primaryEarly 2015——HR 0.80 (95% CI 0.68–0.93)Rate ratio, not a hazard ratio.
Breast cancer mortalityAll three comparison types aggregatedprimaryEarly 2015——HR 0.86 (95% CI 0.80–0.94)P=0.0005Rate ratio, not a hazard ratio.
All-cause mortalityAll three comparison types aggregatedprimaryEarly 2015——HR 0.88 (95% CI 0.82–0.94)P=0.0003Rate ratio, not a hazard ratio.
Hazard ratio (95% CI) by endpoint. Values below 1 favour the experimental arm.
Breast cancer mortalityAny first recurrenceAny first recurrenceBreast cancer mortalityAll-cause mortality0.512◀ experimentalcontrol ▶
Data table
EndpointHR95% CI
Breast cancer mortality0.850.75–0.96
Any first recurrence0.640.52–0.78
Any first recurrence0.80.68–0.93
Breast cancer mortality0.860.8–0.94
All-cause mortality0.880.82–0.94
Primary publication: Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet. 2015;386(10001):1341-1352. PubMedDOI

Appears in

Sources

  1. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet. 2015;386(10001):1341-1352.

    PubMedDOI