Treatment of stage D2 prostatic cancer refractory to or relapsed following castration plus oestrogens. Comparison of aminoglutethimide plus hydrocortisone with medroxyprogesterone acetate plus hydrocortisone.
A total of 59 patients with advanced prostate cancer relapsed from or refractory to castration plus oestrogen were treated in a randomised trial comparing 1000 to 1250 mg aminoglutethimide + 40 mg hydrocortisone (AG + HC) with 500 mg medroxyprogesterone acetate + 40 mg hydrocortisone (MPA + HC). A significantly higher objective response rate and better symptomatic control was noted in patients treated with AG + HC (31%) compared with those treated with MPA + HC (3%). The median time to treatment failure was also significantly longer for patients treated with AG + HC. These findings suggest a role for AG in the treatment of advanced prostate cancer. While both second-line hormone treatment regimens resulted in significant suppression of adrenal androgen secretion, the differences in response rate could not be explained by alterations in peripheral blood hormone levels. AG in high doses may have cellular effects which require further study.
Bezwoda
W R
WR
Department of Medicine, Haematology/Oncology, University of the Witwatersrand Medical School, Johannesburg, South Africa.
D000368:Aged; D000616:Aminoglutethimide / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000556:secondary; D003131:Combined Modality Therapy; D004054:Diethylstilbestrol / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D008297:Male; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000031:analogs & derivatives; D017258:Medroxyprogesterone Acetate; D009367:Neoplasm Staging; D009919:Orchiectomy; D011184:Postoperative Period; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016032:Randomized Controlled Trials as Topic
D000616:Aminoglutethimide; D004054:Diethylstilbestrol; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; D006854:Hydrocortisone