Nomura Y, Tashiro H, Hisamatsu K, Shinozuka K
Department of Breast Surgery, National Kyushu Cancer Center Hospital, Fukuoka, Japan.
Anticancer Res. 1988 Jul-Aug;8(4):647-51.
Forty-six patients with advanced breast cancer were treated with oral high-dose medroxyprogesterone acetate (MPA) as a second line endocrine treatment, with a 28% 13/46) response rate. There was a significant difference in response to MPA between patients with estrogen (ER)- or progesterone (PgR)-receptors and those with negative receptors assayed just before the treatment (ER+, 7/10, ER-, 0/9 of response rates, p = 0.007, PgR+, 4/4: PgR-, 3/15, p = 0.02). The combination of ER and PgR was observed to be best in predicting the response (p = 0.02). The ER status as well as the combination of ER and PgR, but not PgR alone detected in the primary tumors, correlated well with the response (ER+, 10/23: ER-, 0/15, p = 0.0094, PgR+: PgR-, p = 0.13, ER+PgR+, ER+PgR-, ER-PgR-:p = 0.024). The correlation between steroid hormone receptors and response to MPA in advanced breast cancer was established from the literature. Response rate to MPA was shown to be 42% (69/169) in ER+ cancer patients, and 10% (9/90) in ER- cancer patients (p = 0.00004). There was no correlation between PgR status and the response. Changes of receptors were studied in relation to the response. When ER+ or PgR+ tumors retained their positivity until MPA treatment, a good response was obtained, while there were almost no responders if one or both receptors changed from positive to negative, or remained negative. In conclusion, the response to MPA can be predicted by the steroid hormone receptors.
46例晚期乳腺癌患者接受口服大剂量醋酸甲羟孕酮（MPA）作为二线内分泌治疗，有效率为28%（13/46）。雌激素（ER）或孕激素（PgR）受体阳性患者与治疗前检测受体阴性患者对MPA的反应存在显著差异（ER+，反应率7/10，ER-，0/9，p = 0.007；PgR+，4/4；PgR-，3/15，p = 0.02）。观察到ER和PgR联合检测在预测反应方面最佳（p = 0.02）。原发肿瘤中检测到的ER状态以及ER和PgR联合检测结果，但不包括单独的PgR检测结果，与反应密切相关（ER+，10/23；ER-，0/15，p = 0.0094；PgR+：PgR-，p = 0.13；ER+PgR+、ER+PgR-、ER-PgR-：p = 0.024）。从文献中确立了晚期乳腺癌中甾体激素受体与对MPA反应之间的相关性。ER+乳腺癌患者对MPA的反应率为42%（69/169），ER-乳腺癌患者为10%（9/90）（p = 0.00004）。PgR状态与反应之间无相关性。研究了受体变化与反应的关系。当ER+或PgR+肿瘤在MPA治疗前保持阳性时，可获得良好反应，而如果一个或两个受体从阳性变为阴性或保持阴性，则几乎没有反应者。总之，甾体激素受体可预测对MPA的反应。
