ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Absolute Improvements in Freedom From Distant Recurrence to Tailor Adjuvant Endocrine Therapies for Premenopausal Women: Results From TEXT and SOFT.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
76 citing papers in PubMed, 6 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Association of progesterone receptor status with breast cancer prognosis: a meta-analysis.World journal of surgical oncology · 2025Pooled it
- [Systemic treatment of breast cancer: professional guideline].Magyar onkologia · 2025Guideline
- Safety of systemic hormone replacement therapy in breast cancer survivors: a systematic review and meta-analysis.Breast cancer research and treatment · 2022Pooled it
- Systemic Treatment of Breast Cancer. 1st Central-Eastern European Professional Consensus Statement on Breast Cancer.Pathology oncology research : POR · 2022Pooled it
- Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021.Annals of oncology : official journal of the European Society for Medical Oncology · 2021Guideline
- Development and Validation of a Tool Integrating the 21-Gene Recurrence Score and Clinical-Pathological Features to Individualize Prognosis and Prediction of Chemotherapy Benefit in Early Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Pooled it
- Adjuvant Endocrine Therapy in Premenopausal Breast Cancer: 12-Year Results From SOFT.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Twenty-Year Benefit From Adjuvant Goserelin and Tamoxifen in Premenopausal Patients With Breast Cancer in a Controlled Randomized Clinical Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- 21-Gene Assay to Inform Chemotherapy Benefit in Node-Positive Breast Cancer.The New England journal of medicine · 2021Trial
- Prospective assessment of incomplete ovarian suppression in breast cancer using LC-MS/MS and immunoassays for estradiol.Breast (Edinburgh, Scotland) · 2026Article
- Response to Wein et al.: Endocrine time zero, endocrine effect? Re-reading OFS+AI after residual disease.Breast (Edinburgh, Scotland) · 2026Article
- Chemobrain as a Neuroimmune Syndrome: Mechanisms, Modifiers, and Emerging Multi-Target Therapeutic Strategies.Molecules (Basel, Switzerland) · 2026Review
- Development and Validation of a Multimodal Clinical, Pathologic, and Genomic Model for Breast Cancer Recurrence.medRxiv : the preprint server for health sciences · 2026Article
- Considering symptom burden and social relationships during sexual health management in ovarian suppression-treated women with breast cancer.Communications medicine · 2026Article
- Tailoring targeted therapies for younger women with ER-positive early-stage breast cancer.Nature reviews. Clinical oncology · 2026Review
- Response to Verma et al., Letter to the editor.Breast (Edinburgh, Scotland) · 2026Article
- Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer.Breast (Edinburgh, Scotland) · 2026Article
- Treatment Patterns of Goserelin 3.6 mg Once Every 4 Weeks and 10.8 mg Once Every 12 Weeks in Women With Breast Cancer: A Real-World Analysis of Patients in the United States.JCO oncology practice · 2026Article
- The incidence, clinicopathological characteristics and the survival outcomes among young breast cancer patients in Alexandria, Egypt.Ecancermedicalscience · 2026Article
- Evolving Concepts and Contemporary Management of Early-Stage Breast Cancer: An Evidence-Based Approach to Grey Zones from a Comprehensive Breast Unit Part 2: Systemic Treatment.European journal of breast health · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 13 institutions in 7 countries.
Funding
Abstract
purposeThe Tamoxifen and Exemestane Trial (TEXT)/Suppression of Ovarian Function Trial (SOFT) showed superior outcomes for premenopausal women with hormone receptor (HR)-positive breast cancer treated with adjuvant exemestane plus ovarian function suppression (OFS) or tamoxifen plus OFS versus tamoxifen alone. We previously reported the magnitude of absolute improvements in freedom from any recurrence across a continuous, composite measure of recurrence risk to tailor decision making. With longer follow-up, we now focus on distant recurrence.
methodsThe TEXT/SOFT HR-positive/human epidermal growth factor receptor 2 (HER2)-negative analysis population included 4,891 women stratified by predetermined chemotherapy use. Kaplan-Meier estimates of 8-year freedom from distant recurrence were analyzed using subpopulation treatment effect pattern plot (STEPP) methodology across subpopulations defined by the continuous composite measure of recurrence risk. For each patient, the composite risk value was obtained from a Cox model that incorporated age; nodal status; tumor size; grade; and estrogen receptor, progesterone receptor, and Ki-67 labeling index expression levels.
resultsThe overall rate of 8-year freedom from distant recurrence was 91.1% and ranged from approximately 100% to 63% across lowest to highest composite risks. TEXT patients who received chemotherapy had an average absolute improvement with exemestane plus OFS versus tamoxifen plus OFS of 5.1%, and STEPP analysis showed improvements from less than 1% to more than 15% from lowest to highest composite risks. SOFT patients who remained premenopausal after chemotherapy had an average 5.2% absolute improvement with exemestane plus OFS versus tamoxifen and reached 10% across composite risks; for tamoxifen plus OFS versus tamoxifen, the maximum improvement was approximately 3.5%. Women who did not receive chemotherapy had a more than 97% rate of 8-year freedom from distant recurrence, and improvements with exemestane plus OFS ranged from 1% to 4%.
conclusionPremenopausal women with HR-positive/HER2-negative breast cancer and high recurrence risk, as defined by clinicopathologic characteristics, may experience a 10% to 15% absolute improvement in 8-year freedom from distant recurrence with exemestane plus OFS versus tamoxifen plus OFS or tamoxifen alone. The potential benefit of escalating endocrine therapy versus tamoxifen alone is minimal for those at low recurrence risk.
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