Sawka C A, Pritchard K I, Paterson A H, Sutherland D J, Thomson D B, Shelley W E, Myers R E, Mobbs B G, Malkin A, Meakin J W
Cancer Res. 1986 Jun;46(6):3152-6.
Tamoxifen was evaluated as initial hormone therapy for metastatic breast cancer in 85 premenopausal patients. Tamoxifen responders continued on tamoxifen, while tamoxifen failures and initial responders who later progressed were to receive ovarian ablation next. Of 74 evaluable patients, 5 had complete responses (CR) and 15 had partial responses (PR) while 12 remained stable (ST), giving response rates of 27% (CR + PR) or 43% (CR + PR + ST). Of the 23 patients who initially responded (CR + PR + ST) to tamoxifen but then progressed and received ovarian ablation alone, 15 are assessable. Nine (60%) responded (CR + PR + ST) to ovarian ablation. Sixteen patients who failed tamoxifen had ovarian ablation alone, and of 14 assessable patients 2 had ST while 12 progressed. Thus response to tamoxifen strongly predicted response to ovarian ablation (P = 0.021). Serial follicle stimulating hormone, prolactin, and estradiol levels suggested that tamoxifen does not act by induction of a "medical ovariectomy" or by alteration of prolactin levels in premenopausal patients.
对85例绝经前转移性乳腺癌患者进行了他莫昔芬作为初始激素治疗的评估。他莫昔芬治疗有效的患者继续使用他莫昔芬，而他莫昔芬治疗无效的患者以及后来病情进展的初始有效患者接下来将接受卵巢去势治疗。在74例可评估患者中，5例完全缓解（CR），15例部分缓解（PR），12例病情稳定（ST），缓解率为27%（CR + PR）或43%（CR + PR + ST）。在最初对他莫昔芬有反应（CR + PR + ST）但后来病情进展并仅接受卵巢去势治疗的23例患者中，15例可评估。9例（60%）对卵巢去势有反应（CR + PR + ST）。16例他莫昔芬治疗失败的患者仅接受卵巢去势治疗，在14例可评估患者中，2例病情稳定，12例病情进展。因此，对他莫昔芬的反应强烈预示着对卵巢去势的反应（P = 0.021）。连续的促卵泡生成素、催乳素和雌二醇水平表明，他莫昔芬在绝经前患者中并非通过诱导“药物性卵巢切除”或改变催乳素水平起作用。
