The Study of Tamoxifen and Raloxifene (STAR) Trial

  • The NSABP P-2, or STAR trial:
    • Enrolled 19,747 postmenopausal women with a 5-year Gail risk assessment score of  1.66% for the development of invasive breast cancer at 5 years
    • The women were randomized to receive:
      • 20 mg of tamoxifen plus placebo or 60 mg of raloxifene plus placebo
    • The updated results of the STAR trial (median follow-up 81 months):
      • Reported more cases of invasive breast cancer in the raloxifene group than the tamoxifen group (risk ratio [RR]: 1.24; 95% confidence interval [CI]: 1.05–1.47):
        • Demonstrating that raloxifene is about 76% as effective as tamoxifen in reducing breast cancer risk
      • There were significantly fewer cases of invasive uterine cancer with raloxifene compared to tamoxifen (RR: 0.55; 95% CI, 0.36–0.83)
      • Thromboembolic events occurred less often in the raloxifene group (RR: 0.75; 95% CI: 0.6–0.93)
      • There were fewer cataracts and cataract surgeries in the women taking raloxifene (RR: 0.79; 95% CI: 0.68–0.92)
      • Importantly, there was no significant difference in mortality between the two groups
  • References
    • Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, et al; for the National Surgical Adjuvant Breast and Bowel Project (NSABP). Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA. 2006;295(23):2727-2741.
    • Vogel VG. The NSABP Study of Tamoxifen and Raloxifene (STAR) trial. Expert Rev Anticancer Ther. 2009;9(1):51-60.
    • Mamounas EP, Wicherham DL, Fisher B, Geyer CE, Julian TB, Wolmark N. The NSABP experience. In: Kuerer HM, ed. Kuerer’s Breast Surgical Oncology. New York, NY: McGraw-Hill Companies; 2010:475-508.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #NSABPP2 #Raloxifen #Tamoxifen

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