The use of high-dose megestrol acetate in the treatment of ovarian adenocarcinoma.

This study investigated the use of a progestin, megestrol acetate, in high doses for 34 patients with ovarian adenocarcinoma and related gynecologic tumors. Megestrol acetate was administered in doses of 800 mg/d orally for one month, followed by 400 mg/d until the first signs of progression of disease. Of 23 evaluable patients, seven patients showed a complete response and four patients a partial response. Ten of the responders had ovarian adenocarcinoma, and one, who is alive and free of disease 96 months after treatment, had a mesothelioma. The remaining six patients achieving complete response survived from 5 to 36 months, and those achieving partial response survived from 4 to 10 months. In contrast, studies of progestins administered in conventional doses to ovarian carcinoma patients have yielded minimal response at best. Our results confirm the benefits of high-dose progestins for ovarian carcinomas and related gynecologic tumors and warrant further investigation of hormonal therapy for this patient group.