In an interview and a memoir, V. Craig Jordan spoke about his life and SERMs

So, Haddow, in his Karnofsky lecture said, “It’s really sad because nobody’s particularly interested in finding out why this happens. It’s a very important observation for a few patients, but it’s not enough to make a difference.”

So, when I won my Karnofsky Lecture years later, I basically dedicated it to Alexander Haddow, and said, “We figured it out. We know why that happens,” and he had in his paper all the requirements: they had to be five years after the menopause. If it was before the menopause, estrogen treatment for breast cancer didn’t work. So, they had to be estrogen-starved for a period of time.

Shortly after Craig Jordan finished his PhD in the 1970s, he was invited by Michael Harper to work at the Worcester Foundation, the “home of the oral contraceptive.”

Jordan arrived only to find that Harper had left for Geneva, leaving the recent graduate on his own. “I don’t know anything!” Jordan, professor of breast medical oncology as well as molecular and cellular oncology at MD Anderson Cancer Center, said at the time.

Harper was the co-patent holder of ICI’s experimental drug 46,474, which had failed as an oral contraceptive.

So, Jordan decided to work with what he had.

“‘Why don’t we turn ICI 46,474 into a breast cancer drug?’ There’s been one publication on that and it shows it’s as good as estrogen,” Jordan, who is also a member of the U.S. National Academy of Sciences and the National Academy of Medicine and an honorary fellow  of the Royal Society of Medicine, said.

ICI 46,474 would later come to become known as tamoxifen, and Jordan’s work would change the face of breast cancer prevention and treatment for the next 30 years.

Recently, Jordan published a scientific memoir, “Tamoxifen Tales: Suggestions for Scientific Survival” (The Cancer Letter, May 27, 2022).

Jordan’s early animal studies with tamoxifen showed promise, and his career gained speed as he presented these results around the country. Jordan’s animal studies also showed that cancer in rats was hormone-dependent.

“You could take the ovaries out, the tumors would regress, you could take the ovaries out, put the carcinogen in, then they wouldn’t get tumors, because you needed estrogen to do that,” he said.

“So, I did studies on prevention for the first time, and did the first presentations at international meetings on that. What if we could prevent breast cancer? They hadn’t invented prevention at that time. So, you’re talking to a brick wall,” Jordan said. “Prevent breast cancer? Oh God, here comes Craig Jordan talking about tamoxifen again. Pretend you haven’t seen him.”

One would get little quarrel with the hypothesis that the development of “targeted therapy” is one of the most substantial advances in cancer care and cancer research over the past 50 years. 

In fact, my colleague Eric Rosenthal and I recently conducted a poll, published in “Centers of the Cancer Universe,” of more than 100 cancer leaders and scientists, asking each what they judged to be the most important advances in cancer research since the signing of the National Cancer Act on Dec. 23, 1971. 

Of the responses, 70% noted advances in immunology and the development of immune checkpoint inhibitors, 65% cited discoveries in genetics and genomics and the Human Genome Project, and 62% voted for the development of “targeted therapies” —the most frequently cited being receptor tyrosine kinase inhibitors (e.g., imatinib), monoclonal antibodies (e.g., trastuzumab). 

Interestingly, tamoxifen was mentioned by only a few respondents. It is very easy to argue, however, that tamoxifen was one of the first targeted therapies, having been studied initially in the mid-1960s as a contraceptive; rather shortly after failing in that application was picked up and studied by a young British PhD student at Leeds University in the early 1970s, V. Craig Jordan.