Trial reportInternational journal of cancer2026
Long-term benefit from adjuvant tamoxifen therapy for ER+ HER2- breast cancer by PR positivity.
Trial report in International journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
9 authors.
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Abstract
We aimed to evaluate the long-term tamoxifen benefit by progesterone receptor (PR) levels in postmenopausal lymph node-negative breast cancer patients with estrogen receptor (ER)-positive/human epidermal growth factor receptor 2-negative (HER2) tumors in the STO-3 randomized trial. This is a secondary analysis of the STO-3 trial including 559 postmenopausal breast cancer patients by PR levels. Patients were randomly assigned to at least 2 years of adjuvant tamoxifen therapy (40 mg once daily) versus no endocrine therapy in the Stockholm (STO)-3 trial. Twenty-five-year distant recurrence-free interval (DRFI) was assessed by Kaplan-Meier, multivariable Cox proportional hazard regression, and multivariable time-varying analyses. Univariable Kaplan-Meier analysis showed a significant long-term tamoxifen benefit for PR-positive disease using a threshold of 10% or greater (DRFI, tamoxifen treated 85% vs. control 68%; p < .0001). Similarly, patients with high PR gene expressing tumors had a significant long-term tamoxifen therapy benefit (DRFI, tamoxifen treated 84% vs. control 66%; log-rank p < .001). In contrast, we report no significant therapy benefit for patients with PR-negative disease (DRFI, tamoxifen treated 79% vs. control 70%; log-rank p = .14) or low PR gene expression (DRFI, tamoxifen treated 82% vs. control 74%; log-rank p = .17). Multivariable Cox proportional hazard regression modelling confirmed the univariable findings for PR-positive disease (HR = 0.37; 95% CI [0.23-0.61]). Time-varying analysis revealed a treatment benefit for PR-positive disease up to 25 years (HR = 0.35; 95% CI [0.16-0.79]), but not for patients with PR-negative tumors. PR-positivity as determined by immunohistochemistry predicted long-term benefit from adjuvant tamoxifen in lymph node-negative postmenopausal breast cancer patients with ER+/HER2- tumors.
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