Megestrol acetate in the treatment of metastatic breast cancer

There are many non-elucidated questions concerning cancer, especially of the breast, in which hormones are involved. The scope of this particular study is to bring more clarity on the role of the progestin megestrol acetate in the hormonal treatment of breast cancer. It should be kept in mind that this is a clinical study. Biochemical details mentioned in Chapter I serve primarily as a background for a better understanding of clinical effects. The study was done from 1974-1983 and 5 questions have provided the frame for this thesis: l. How effective is megestrol acetate in the treatment of metastatic breast cancer? (Chapter II) 2. What is the role of steroid receptors in the mechanism of action of megestrol acetate in inducing tumor regression? (Chapter III + IV) 3. Has the effect of megestrol acetate on some endocrine parameters any relation to tumor regression? What is the optimal dose? (Chapter V) 4. In what sequence of hormonal treatment should megestrol acetate be used? Is there a difference with regard to the age and/or menopausal state of the patient? (Chapter VI) S. Does the combination of megestrol acetate and tamoxifen have any additional effect on endocrine events; especially can megestrol acetate-induced hyperprolactinaemia be suppressed by the administration of tamoxifen? (Chapter VII) These questions are considered in the general discussion and summar

Weekly low-dose mitoxantrone plus doxorubicin as second-line chemotherapy for advanced breast cancer

Weekly low dose mitoxantrone (3 mg/m2) plus doxorubicin (8 mg/m2) was administered as second-line chemotherapy to 33 patients with advanced breast cancer. Four out of 28 evaluable patients (14%) obtained a partial response with a median duration of 34 weeks (range 18-67+ weeks), while 8 patients (29%) showed stable disease with a median duration of 28 weeks (range 11+-60 weeks). Gastrointestinal toxicity and alopecia were mild. Grade II and III leukopenia occurred in 63% of the courses without serious infectious disease. Four patients experienced an asymptomatic drop of 16-20% in the left ventricular ejection fraction (LVEF) after relatively low cumulative doses of each drug, and one patient with a history of pericarditis carcinomatosa and mediastinal irradiation developed a heart failure. In conclusion, this second-line combination treatment had moderate activity in breast cancer and caused only few subjective side effects, especially with respect to gastrointestinal symptoms