Chemotherapy with or without high-dose medroxyprogesterone acetate in oestrogen-receptor-negative advanced breast cancer. Norwegian Breast Cancer Group.
In a randomised study 142 patients with advanced oestrogen-receptor-negative breast cancer in the tumour tissue received chemotherapy alone or chemotherapy combined with high doses (1000 mg daily) of oral medroxyprogesterone acetate (HD-MPA). Of the 126 fully evaluable for response, the response rates were 46% for chemotherapy alone and 73% for chemotherapy with HD-MPA (P = 0.005). There was no significant difference with regard to duration of response. Of the 138 patients evaluable for survival and toxicity, survival was shorter in the combined treatment group; median survival of 9 versus 13 months (P less than 0.05). Considerable toxicity was seen from HD-MPA, especially weight gain and fluid retention. The present study provides evidence that in concordance with preclinical studies an interaction between chemotherapy and HD-MPA may exist in breast cancer normally resistant to hormone therapy. The side-effects from MPA were substantial, however, and the survival data are of great concern.
Gundersen
S
S
Department of Oncology, Norwegian Radium Hospital, Oslo.
Kvinnsland
S
S
Klepp
O
O
Lund
E
E
Hannisdal
E
E
Høst
H
H
D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008525:Medroxyprogesterone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis*; D014750:Vincristine / Q000008:administration & dosage
D000970:Antineoplastic Agents; D008937:Mitomycins; D009363:Neoplasm Proteins; D011960:Receptors, Estrogen; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; D005472:Fluorouracil