Nemoto T, Patel J K, Rosner D, Dao T L, Halvorson H
Department of Breast Surgery, Roswell Park Memorial Institute, Buffalo, NY.
J Surg Oncol. 1989 Aug;41(4):226-9. doi: 10.1002/jso.2930410407.
A clinical trial of sequential tamoxifen and medroxyprogesterone acetate (MPA) was carried out in 36 women with metastatic breast cancer in order to evaluate the therapeutic efficacy of this regimen and to determine if tamoxifen would increase progesterone receptor (PR) levels and thereby increase response to MPA. Fourteen patients (39%) responded to this treatment, with the duration of remission ranging from 2 to 24 + months (the mean and median were 11 months). In 22 patients, PR levels were measured both before and after 7 days of tamoxifen administration. In PR-positive patients, PR changes induced by tamoxifen did not appear to increase the response rate. In PR-negative patients, PR became positive in 3 patients following tamoxifen treatment, with 2 of 3 responding to treatment, whereas in 11 others whose PR levels remained negative, only one response was observed. Our results suggest that potentiation by tamoxifen was not observed, since in our previous study, MPA alone was equally effective. Thus, tamoxifen and MPA should be given independently for palliation of metastatic breast cancer, and MPA should be administered following therapy with tamoxifen.
对36例转移性乳腺癌女性患者进行了他莫昔芬与醋酸甲羟孕酮（MPA）序贯治疗的临床试验，以评估该治疗方案的疗效，并确定他莫昔芬是否会提高孕激素受体（PR）水平，从而增强对MPA的反应。14例患者（39%）对该治疗有反应，缓解期为2至24 +个月（平均和中位数为11个月）。在22例患者中，在给予他莫昔芬7天前后均测量了PR水平。在PR阳性患者中，他莫昔芬诱导的PR变化似乎并未提高反应率。在PR阴性患者中，3例患者在他莫昔芬治疗后PR转为阳性，其中2例对治疗有反应，而在另外11例PR水平仍为阴性的患者中，仅观察到1例有反应。我们的结果表明未观察到他莫昔芬的增效作用，因为在我们之前的研究中，单独使用MPA同样有效。因此，对于转移性乳腺癌的姑息治疗，他莫昔芬和MPA应单独给药，且应在他莫昔芬治疗后给予MPA。
