Hormonal palliation of chemoresistant ovarian cancer: three consecutive phase II trials of the Mid-Atlantic Oncology Program.
OBJECTIVE
To evaluate the efficacy of three hormonal manipulations in the palliation of chemoresistant ovarian cancer, and to analyze the results in the light of other clinical trials.


METHODS
Three sequential phase II trials were performed in patients with refractory epithelial ovarian carcinoma, using high-dose megestrol acetate (800 mg/d for 30 days, then 400 mg/d), high-dose tamoxifen (80 mg/d for 30 days, then 40 mg/d), and aminoglutethimide (1 g/d plus tapering doses of hydrocortisone). Results were compared with those described in the world literature from trials of the same or similar agents.


RESULTS
No responses were seen among 30 assessable patients treated with megestrol acetate, and most (but not all) similar trials have reported low response rates. Five responses (17%) were seen among 29 patients treated with tamoxifen. Two responses exceeded 5 years in duration. No responses were seen among 15 patients treated with aminoglutethimide.


CONCLUSIONS
Antiestrogen therapy may offer the possibility of useful and, occasionally, long-term palliation of refractory epithelial ovarian carcinoma, with little toxicity. There may be a trend toward a dose-response effect, which represents a suitable topic for a future prospective trial.
Ahlgren
J D
JD
Division of Hematology/Oncology, George Washington University Medical Center, Washington, DC 20037.
Ellison
N M
NM
Gottlieb
R J
RJ
Laluna
F
F
Lokich
J J
JJ
Sinclair
P R
PR
Ueno
W
W
Wampler
G L
GL
Yeung
K Y
KY
Alt
D
D
D000230:Adenocarcinoma / Q000188:drug therapy; D000616:Aminoglutethimide / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008535:Megestrol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019290:Megestrol Acetate; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010166:Palliative Care; D013629:Tamoxifen / Q000627:therapeutic use*
D013629:Tamoxifen; D000616:Aminoglutethimide; D008535:Megestrol; D019290:Megestrol Acetate; D006854:Hydrocortisone