Re: Randomized Trial of Letrozole Following Tamoxifen as Extended Adjuvant Therapy in Receptor-Positive Breast Cancer: Updated Findings from NCIC CTG MA.17

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Abstract
I read with great interest the updated findings of the NCIC CTG MA.17 trial ( 1 ) and want to compliment the authors for continuing to report on this paradigm-shifting trial. Although the conclusions about the main endpoints remain essentially unchanged compared with those in the original (2003) report of the trial ( 2 ) ( Table 1 ), the two reports include different numbers of patients at risk and—correspondingly—different numbers of breast cancer events. The differences are unlikely to be explained by the difference in duration of follow-up, which is only 1.5 months. Instead, they are due to the thoroughness with which the patient follow-up was updated for the more recent report. However, if so, the difference raises the question of whether the completeness of follow-up should have been taken into consideration before the Data Safety and Monitoring Committee's decision to terminate this study prematurely.