Combined endocrine treatment of elderly postmenopausal patients with metastatic breast cancer; A randomized trial of tamoxifen vs. tamoxifen + aminoglutethimide and hydrocortisone and tamoxifen + fluoxymesterone in women above 65 years of age
| Autor: | Per Dombernowsky, Henning T. Mouridsen, Knud Aage Møller, Ib Jarle Christensen, Lars Bastholt, Jørn Andersen, Martin Andersson, Carsten Rose, Claus Kamby, Pia Munkholm |
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| Rok vydání: | 2000 |
| Předmět: |
Selective Estrogen Receptor Modulators
Oncology Cancer Research medicine.medical_specialty Antineoplastic Agents Hormonal Hydrocortisone Fluoxymesterone Salvage therapy Breast Neoplasms Context (language use) Breast cancer stomatognathic system Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Life Tables Enzyme Inhibitors Neoplasm Metastasis skin and connective tissue diseases Aged Aged 80 and over Salvage Therapy Aromatase Inhibitors business.industry Drug Synergism Antiestrogen medicine.disease Aminoglutethimide Survival Analysis Metastatic breast cancer Neoplasm Proteins Tamoxifen Treatment Outcome Endocrinology Disease Progression Female business hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Breast Cancer Research and Treatment. 61:103-110 |
| ISSN: | 1573-7217 0167-6806 |
| DOI: | 10.1023/a:1006460925986 |
| Popis: | The efficacy of combined endocrine therapy with tamoxifen (TAM), aminoglutethimide (AG), and hydrocortisone (H) or tamoxifen and fluoxymesterone (FLU) was evaluated against treatment with tamoxifen alone in 311 patients above 65 years of age with a first recurrence of a metastatic breast cancer. A total of 279 patients were eligible. The response rates were assessed for 258 fully evaluable patients and were the following for the TAM (N = 94), the TAM+AG+H (N = 83), and the TAM+FLU (N = 81) groups, respectively, PR: 14, 18, and 21%, and CR: 20, 11, and 23%. The overall response rates are not statistically different (p = 0.30). The 95% CL of difference in response rates for TAM vs. TAM+AG+H are -9-19% and for TAM vs. TAM+FLU -4-25%. Time to treatment failure was comparable with median values of 9.2, 7.7, and 9.2 months in the TAM, TAM+AG+H, and TAM + FLU group, respectively (p = 0.17). The corresponding figures for survival are median times of 22.0, 24.1, and 21.1 months with a p-value of 0.62. Toxicity was more pronounced in both the combined treatment groups, and could in most instances be attributed to treatment with either AG+H or FLU. Currently, new specific aromatase inhibitors with lesser toxicity than AG are being evaluated in combination with TAM for treatment of primary and metastatic breast cancer. In conclusion, the simultaneous use of TAM and AG +H or FLU does not seem to improve the therapeutic efficacy in elderly postmenopausal patients with metastatic disease. So far, combined endocrine therapy in this group of patients should only be used in the context of clinical trials. |
| Databáze: | OpenAIRE |
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