In the early 1970's, a failed postcoital contraceptive, ICI 46,474, was reinvented as tamoxifen, the first targeted therapy for breast cancer. A cluster of papers published in the European Journal of Cancer described the idea of targeting tamoxifen to patients with oestrogen receptor positive tumours, and proposed the strategic value of using long-term tamoxifen therapy in an adjuvant setting with a consideration of the antitumour properties of the hydroxylated metabolites of tamoxifen. At the time, these laboratory results were slow to be embraced by the clinical community. Today, it is estimated that hundreds of thousands of breast cancer patients are alive today because of targeted long-term adjuvant tamoxifen therapy. Additionally, the first laboratory studies for the use of tamoxifen as a chemopreventive were published. Eventually, the worth of tamoxifen was tested as a chemopreventive and the drug is now known to have an excellent risk benefit ratio in high risk premenopausal women. Overall, the rigorous investigation of the pharmacology of tamoxifen facilitated tamoxifen's ubiquitous use for the targeted treatment of breast cancer, chemoprevention and pioneered the exploration of selective estrogen receptor modulators (SERMs). This new concept subsequently heralded the development of raloxifene, a failed breast cancer drug, for the prevention of osteoporosis and breast cancer without the troublesome side effect of endometrial cancer noted in postmenopausal women who take tamoxifen. Currently, the pharmaceutical industry is exploiting the SERM concept for all members of the nuclear receptor superfamily so that medicines can now be developed for diseases once thought impossible.A new dynasty gives dominion over the ruling dynasty through perseverance and not by sudden action (Ibn Khaldun 14 th Century Arab Historian) -and so it is with changes in the approach to cancer therapy. This article will focus specifically on a cluster of scientific papers (1-3) published in the European Journal of Cancer that presaged the dramatic changes that have occurred in the past 35 years in our approach to cancer therapy. To set the scene, it is first appropriate to describe the research and treatment philosophy for breast cancer before tamoxifen.In the 1960's, the use of combination cytotoxic chemotherapy for the treatment of breast cancer had moved to center stage in the wake of an abstract presented at the American Association for Cancer Research (4). The cytotoxic "cocktail" presented by Cooper, containing cyclophosphamide, methotrexate, 5 fluorouracil, vincristine and prednisone (CMFVP), produced a dramatic response rate of >80% in patients with advanced breast cancer. In the 1960's, there was every reason to believe that cancer would be curable if 1) the right drug Correspondence: V. Craig Jordan, OBE, PhD, DSc, Vice President and Research Director for Medical Sciences, Alfred G. Knudson Chair of Cancer Research, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, Phone: (215) Fax: (215) ...