Trilostane with hydrocortisone in treatment of metastatic breast cancer.
Twenty-six patients with metastatic breast cancer who had previously responded to one or more endocrine therapies participated in a clinical trial of the combination of trilostane and hydrocortisone for subsequent disease progression. Of these, one patient achieved complete remission (4%), and five had partial response (19%). The median time to progression from initiation of therapy for responding patients was six months (range: 4 - 32 + months). Major toxicities included nausea/vomiting (16 patients), facial flushing (14), abdominal cramping (11), and oral paresthesia (10). Therapy was discontinued in four patients (15%) because of drug intolerance. Fourteen patients who failed trilostane were treated with aminoglutethimide and hydrocortisone. Six patients showed objective response (PR + MR). These data show that trilostane and hydrocortisone in combination can produce an objective response in a significant fraction of patients and that the combination has a different spectrum of toxicity from aminoglutethimide/hydrocortisone. A small number of patients crossed over to aminoglutethimide showed a few objective responses, suggesting a partial lack of cross-resistance between the two antiadrenal drugs.
Chu
P S
PS
Department of Medical Oncology (Breast Medical Oncology), University of Texas M.D. Anderson Cancer Center, Houston 77030.
Buzdar
A U
AU
Hortobagyi
G N
GN
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002986:Clinical Trials as Topic; D013196:Dihydrotestosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D014839:Vomiting / Q000139:chemically induced
D013196:Dihydrotestosterone; C009954:trilostane; D006854:Hydrocortisone