Twenty-year benefit from adjuvant goserelin and tamoxifen for premenopausal ER-positive breast cancer

The Stockholm trial randomized premenopausal patients with ER-positive breast cancer to two years of adjuvant goserelin, tamoxifen, goserelin plus tamoxifen, or no adjuvant treatment. Compared to no treatment, all three treatments were associated with improved long-term distant recurrence-free interval. Genomic low-risk patients significantly benefitted from tamoxifen, while genomic high-risk patients benefitted from goserelin. The authors conclude that the study shows 20-year benefit from 2 years of adjuvant endocrine therapy in ER-positive premenopausal patients and suggests differential treatment benefit on the basis of tumor genomic characteristics.