Document Detail

Comparison of antiestrogen and progestogen therapy for initial treatment and consequences of their combination for second-line treatment of recurrent breast cancer.
MedLine Citation:
PMID:  2259927     Owner:  NLM     Status:  MEDLINE    
A randomized clinical trial involving postmenopausal patients with estrogen receptor positive recurrent breast cancer is reported. Of 168 patients entered, 156 were evaluable, of whom 79 received oral tamoxifen citrate 10 mg twice daily and 77 oral megestrol acetate 40 mg four times a day. Partial response (PR) plus complete response (CR) rates (both arms, 34%) and time-to-disease progression were similar in both arms. Side effects and toxicity were minimal with both regimens, although more patients who received tamoxifen complained of hot flushes (33% v 11%) and more patients who received megestrol acetate had a 10% or greater weight gain at 6 months from baseline (51% v 19%). On progression of disease, 73 patients who had achieved a CR, PR, or stable response received the alternative hormonal treatment in addition to the original hormonal therapy. Ten of 40 patients (25%) who began treatment with megestrol acetate had a further CR or PR; none of 33 patients originally receiving tamoxifen had a response when megestrol acetate was added. Similarly, patients who received tamoxifen as an addition to their original megestrol acetate treatment also had a significantly longer time to second progression than did those in the comparative arm. It was concluded that as initial hormonal therapy for relapsed patients, either tamoxifen or megestrol acetate can be used with confidence. However, it is suggested that tamoxifen and megestrol acetate should not be used in combination, except for those few occasions when tamoxifen is added as second-line therapy following a completed megestrol acetate response, and the megestrol acetate is continued for its palliative effects on appetite and weight gain. Possible mechanisms behind these results are discussed.
A H Paterson; J Hanson; K I Pritchard; E Sansregret; S Dahrouge; R S McDermot; S Fine; D F White; M Trudeau; D J Stewart
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Seminars in oncology     Volume:  17     ISSN:  0093-7754     ISO Abbreviation:  Semin. Oncol.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-30     Completed Date:  1991-01-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0420432     Medline TA:  Semin Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  52-62     Citation Subset:  IM    
Tom Baker Cancer Center, Calgary, Alberta, Canada.
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MeSH Terms
Breast Neoplasms / drug therapy*,  mortality,  pathology
Drug Therapy, Combination
Megestrol / administration & dosage,  adverse effects,  analogs & derivatives*,  therapeutic use
Megestrol Acetate
Tamoxifen / administration & dosage*,  adverse effects,  therapeutic use
Reg. No./Substance:
10540-29-1/Tamoxifen; 3562-63-8/Megestrol; 51154-23-5/Megestrol Acetate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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