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262 Adjuvant therapy with tamoxifen in breast cancer. results after four years in node negative patients
87s
260
TREATMENT OF ADVANCED BREASTCANCER WITH TAMOXIFFN AFTER MEGESTROL ACETATE THERAPY AND VICE VERSA, A RETROSPECTIVE STUDY. J. Alexieva-Figusch, J.G.M. Klijn, J. Blank - v-d. Wijst, W.L.J. van Putten, Rotterdamsch Radio-Therapeutisch Instituut/Dr. Daniel den Hoed Kliniek, Rotterdam, The Netherlands. Of 219 postmenopausal pts with metastatic breastcancer and measurable lesions 136 were treated with megestrol acetate (MA)p.o.(180 mg.daily)followed by tamoxifen (TAM) treatment (40 mg.p.d.)in case of progression,while 83 pts were treated with the inversed drug regimen.The interval between treatment with these two drugs was less than 8 weeks. The overall results were: Response 1st therapy 2nd therapy 1st therapy 2nd therapy MA TAM C.R. 8/136)23% 3/132) 6/83) P.R. 23/136) 8,:,17% 9/13219% N.CH. 73/136 54% 38/83 46% 41/80 51% 61;132'46% F. 32/136 27% 31/83 37% 22/80 28% 59/132 45% There was no significant difference between the effect of TAM and MA used as first therapy with a mean duration of response of 13 and 12 mths resp.Although the response rate of TAM as a second line agent was lower than that of MA (9 vs 17%),this appeared not significant (p=O.lO).With respect to survival there was no significant difference between both treatment modalities.In our opinion TAM is more suitable as a first-line agent because of less side effects and effectiveness as a 2nd line drug.
261
SJQ_lEWTIAL Vs. SIMULT~US ADMINISTl?XIX~J OF TAMOXIm AND MElXOXy PRCZSSTERONE ACETATEINADVANCEZUBREASTCANCER. y M. Bnmo, E. Roldan, Diaz B., Senricio Asistencial de Salud, Gas de1 E&ado Associacicn Espanola, Oncologia, Buenos-Aires, Argentina. 69 Patients with disseminated breast cancer entered into this trial. 36 were treated with seguertial hormonotherapy and 33 with simultaneous hormonotherapy. 54 were postmenopausal patients, 10 were castrated and 5 in menopausal phase. In the first schedule the patients were given TX at daily dose of 20 mg/m2 for 15 days, and 1W at daily dose of 350 mg/m2 orally for the next 15 days. In the second schedule the two hormonal agents were administered simultaneously at the same doses. In k&h schedules TX and MAP were given until progression of the disease. Median interval between initial diagnosis and first metastase is 3 years. Ho-Iormone receptors were not measured. Total response in the sequential administraticm is 57.6 % with l/36 CR and 18/36 PR. Total response in the simultaneous administration is 47.2 % with 4/33 CR and 13/33 PR. These results suggest that sequential atiinistration better results than simultaneous cambination (p CO.4).
does not seem to achieve
There were no significant differences in the duration of response. Both treatments were well tolerated. Side effects had the same incidence in the two treated groups (p 10.20). A trend in favour of sequential hornonotherapy appeared when vaginal bleeding was considered (p CO.05). The increase of weight was significantly higher with the simultaneous schedule. The efficacy of treatment was evaluated with the criteria of U.I.C.C.
262
ADJIJVANT THERAPY
WITH TAMOXIFEN
IN BREAST CANCER. RESULTS AFTER FOUR YEARS IN NODE
NEGATIVE
PATIENTS.
C.Bumma,
P.Volterrani,"S.Racca,"F.DiCarlo
Dipartimanto Seventy-two mastectomy.
di Oncologia-Istituto women with
primary
None of them showed
In each tumor the concentration was determined by DCC binding bound per mg cytosol protein. positive.
Forty-three
di Farmacologia, breast
Universita
cancer entered
axillary
into this study after radical
node involvement
of estrogen
di Torino,Italy
or metastases
(ER) and progesterone
assay and the results expressed as fmoles of hormone A concentration higher than 5 fmol/mg was considered
(60%) patients
were
receptor-positive,
while
the remainders
were receptor-negative. All of patients selected for this trial were tamoxifen in the dose of 30 mglday orally for one year. The follow-up the cases, while
after
four years
the overall
elsewhere.
(PgR) receptors
showed
survival
ER level higher
than 40 fmoles/mg
ER level higher
than 20 fmoles showed
local recurrence
or metastasis
rate was 90%. Postmenopausal
cytosol
protein
and premenopausal
no local recurrence
given in about
patients patients
or rcetastases.
10% of
with a with a
260
TREATMENT OF ADVANCED BREASTCANCER WITH TAMOXIFFN AFTER MEGESTROL ACETATE THERAPY AND VICE VERSA, A RETROSPECTIVE STUDY. J. Alexieva-Figusch, J.G.M. Klijn, J. Blank - v-d. Wijst, W.L.J. van Putten, Rotterdamsch Radio-Therapeutisch Instituut/Dr. Daniel den Hoed Kliniek, Rotterdam, The Netherlands. Of 219 postmenopausal pts with metastatic breastcancer and measurable lesions 136 were treated with megestrol acetate (MA)p.o.(180 mg.daily)followed by tamoxifen (TAM) treatment (40 mg.p.d.)in case of progression,while 83 pts were treated with the inversed drug regimen.The interval between treatment with these two drugs was less than 8 weeks. The overall results were: Response 1st therapy 2nd therapy 1st therapy 2nd therapy MA TAM C.R. 8/136)23% 3/132) 6/83) P.R. 23/136) 8,:,17% 9/13219% N.CH. 73/136 54% 38/83 46% 41/80 51% 61;132'46% F. 32/136 27% 31/83 37% 22/80 28% 59/132 45% There was no significant difference between the effect of TAM and MA used as first therapy with a mean duration of response of 13 and 12 mths resp.Although the response rate of TAM as a second line agent was lower than that of MA (9 vs 17%),this appeared not significant (p=O.lO).With respect to survival there was no significant difference between both treatment modalities.In our opinion TAM is more suitable as a first-line agent because of less side effects and effectiveness as a 2nd line drug.
261
SJQ_lEWTIAL Vs. SIMULT~US ADMINISTl?XIX~J OF TAMOXIm AND MElXOXy PRCZSSTERONE ACETATEINADVANCEZUBREASTCANCER. y M. Bnmo, E. Roldan, Diaz B., Senricio Asistencial de Salud, Gas de1 E&ado Associacicn Espanola, Oncologia, Buenos-Aires, Argentina. 69 Patients with disseminated breast cancer entered into this trial. 36 were treated with seguertial hormonotherapy and 33 with simultaneous hormonotherapy. 54 were postmenopausal patients, 10 were castrated and 5 in menopausal phase. In the first schedule the patients were given TX at daily dose of 20 mg/m2 for 15 days, and 1W at daily dose of 350 mg/m2 orally for the next 15 days. In the second schedule the two hormonal agents were administered simultaneously at the same doses. In k&h schedules TX and MAP were given until progression of the disease. Median interval between initial diagnosis and first metastase is 3 years. Ho-Iormone receptors were not measured. Total response in the sequential administraticm is 57.6 % with l/36 CR and 18/36 PR. Total response in the simultaneous administration is 47.2 % with 4/33 CR and 13/33 PR. These results suggest that sequential atiinistration better results than simultaneous cambination (p CO.4).
does not seem to achieve
There were no significant differences in the duration of response. Both treatments were well tolerated. Side effects had the same incidence in the two treated groups (p 10.20). A trend in favour of sequential hornonotherapy appeared when vaginal bleeding was considered (p CO.05). The increase of weight was significantly higher with the simultaneous schedule. The efficacy of treatment was evaluated with the criteria of U.I.C.C.
262
ADJIJVANT THERAPY
WITH TAMOXIFEN
IN BREAST CANCER. RESULTS AFTER FOUR YEARS IN NODE
NEGATIVE
PATIENTS.
C.Bumma,
P.Volterrani,"S.Racca,"F.DiCarlo
Dipartimanto Seventy-two mastectomy.
di Oncologia-Istituto women with
primary
None of them showed
In each tumor the concentration was determined by DCC binding bound per mg cytosol protein. positive.
Forty-three
di Farmacologia, breast
Universita
cancer entered
axillary
into this study after radical
node involvement
of estrogen
di Torino,Italy
or metastases
(ER) and progesterone
assay and the results expressed as fmoles of hormone A concentration higher than 5 fmol/mg was considered
(60%) patients
were
receptor-positive,
while
the remainders
were receptor-negative. All of patients selected for this trial were tamoxifen in the dose of 30 mglday orally for one year. The follow-up the cases, while
after
four years
the overall
elsewhere.
(PgR) receptors
showed
survival
ER level higher
than 40 fmoles/mg
ER level higher
than 20 fmoles showed
local recurrence
or metastasis
rate was 90%. Postmenopausal
cytosol
protein
and premenopausal
no local recurrence
given in about
patients patients
or rcetastases.
10% of
with a with a