Estramustine phosphate sodium in heavily pretreated patients with metastatic breast cancer: a retrospective consecutive case series.
BACKGROUND
Estramustine phosphate sodium (EMP) is an oral agent poorly developed--although active--in patients with metastatic breast cancer (MBC). To resume interest in EMP in MBC, we analyzed a retrospective series of consecutive patients with estrogen receptor-positive disease.


METHODS
EMP was given orally at a dose of 140 mg daily. Treatment discontinuation rates due to progressive disease/toxicity and response rates were assessed.


RESULTS
Twenty postmenopausal patients with mainly visceral disease were treated with EMP, in five cases in combination with other anticancer drugs. Median numbers of previous chemotherapies and hormonal treatments were six and four, respectively. From the entire cohort, one complete response and four partial responses were observed. The proportions of patients free of progression at 6 and 12 months were 39 and 8 %, respectively. Six patients discontinued EMP, three each for toxicity and adverse events.


CONCLUSIONS
Good disease control was obtained in heavily pretreated MBC patients receiving EMP. Toxicity was manageable and reversible although treatment discontinuation has to be considered. A prospective study should be encouraged to identify the optimal use of the drug.
Division of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy, gaetano.aurilio@ieo.it.
Gaetano
G
Aurilio
Rossella
R
Graffeo
Vincenzo
V
Bagnardi
Franco
F
Nolè
Laura
L
Adamoli
Olivia
O
Pagani
Elisa
E
Gallerani
Benvenuto
B
Ferrari
Giancarlo
G
Pruneri
Aron
A
Goldhirsch
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018450:Disease Progression; D004961:Estramustine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D012189:Retrospective Studies
D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D004961:Estramustine