Nordic trials of adjuvant therapy in primary breast cancer

The Scandinavian Breast Group (SBG), established in 1989, has members representing research, diagnosis, and treatment of breast cancer. In 1992 the SBG analyzed ongoing adjuvant trials in the Scandinavian countries. Many trials were analyzing similar questions, but a substantial proportion recruited an insufficient number of patients to enable valid conclusions within a reasonable time. As a result the SBG Clinical Trials Group was established to coordinate and organize trials in primary and advanced disease. Present activities include a study in premenopausal patients with node-positive, receptor-positive disease (CMF vs castration), a study in pre- and postmenopausal patients with node-positive, receptor-negative disease (CMF vs CEF), and a study in high-risk patients aged < 60 years (dose-escalating CEF vs three cycles of CEF followed by high-dose chemotherapy and autologous stem cell support). All these studies are planned to close during 1998. Another study has recently been activated. This enrolls patients with climacteric symptoms given previous treatment for in situ or invasive breast cancer, who are randomized to observation vs hormone replacement therapy for 2 years. Other groups are strongly encouraged to participate. Potential future activities are briefly described. Some of these will be undertaken in international collaboration.