Effect of tamoxifen and high-dose medroxyprogesterone acetate (MPA) on cell-mediated immune functions in breast cancer patients.
In 48 postmenopausal patients with non-disseminated breast cancer an adjuvant therapy with tamoxifen, and in 17 breast cancer patients with disseminated disease a therapy with high-dose medroxyprogesterone acetate (MPA) was performed and the results obtained were compared to a control group of 35 postmenopausal patients with non-disseminated disease receiving no further adjuvant treatment and 9 patients with disseminated disease, who were not treated by hormonal therapy or chemotherapy. Before therapy was started and at the end of therapy reactivity in the leukocyte migration inhibition test (LMI-Test) against autologous and homologous tumor tissue, serum levels of TNF alpha, IL-2 and IFN alpha, as well as the differentiation of different lymphocyte subsets in the peripheral blood, were determined. In patients undergoing adjuvant therapy with tamoxifen an increase of reactivity in the LMI test against tumor tissue (14.6% before and 22.9% after tamoxifen therapy) and increase of the percentage of NK cells (13.6% before and 19.8% after therapy) could be observed, whereas with TNF alpha, IL-2 and IFN alpha serum levels, as well as the differentiation of other lymphocyte subsets, no differences were found. In breast cancer patients with disseminated disease treated with high-dose MPA no changes of LMI reactivity and cytokine serum levels could be observed. We only found a decrease of T-helper cells from 38.4% before to 22.7% (p less than 0.05) at the end of therapy. These results indicate that tamoxifen has no severe suppressive side effects on different parameters of cell-mediated immunity and possibly leads to an increase in the number of NK cells. Contrary to this, high-dose MPA must be considered as a depletor of T-helper cells.
Mallmann
P
P
Department of Gynecology and Obstetrics, University of Bonn, FRG.
Dietrich
K
K
Krebs
D
D
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000276:immunology*; D002464:Cell Migration Inhibition; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007370:Interferon Type I / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D016131:Lymphocyte Subsets / Q000187:drug effects; D008525:Medroxyprogesterone / Q000031:analogs & derivatives* / Q000494:pharmacology; D017258:Medroxyprogesterone Acetate; D008875:Middle Aged; D011446:Prospective Studies; D013629:Tamoxifen / Q000494:pharmacology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000970:Antineoplastic Agents; D007370:Interferon Type I; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D013629:Tamoxifen; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone