Multiple trials of adjuvant chemohormonal therapy in the treatment of breast cancer: preliminary results--the ECOG experience.

Adjuvant therapy trials in breast cancer have grown steadily more complex since 1971, when the first long-term adjuvant trial in the United States was initiated. From L-PAM alone or in combination with a few other cytotoxic agents, ECOG protocols have expanded to consider different multidrug combinations with tamoxifen and other endocrine agents, administered for various lengths of time, sometimes alternating between two combinations. Nevertheless, we are still in the gestational stages of adjuvant studies, with many critical questions yet to be answered.