274 High-dose medroxyprogesterone acetate (MPA) in metastatic cancer patients

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,272 HIGH DOSE PKOGESTIN IN ADVANCED HOEMONO-RELATED CANCER:FAVOUKAELEAND UNFAVOUKAELE EFFECTS. 8. Massidda, V. Mascia, E. Defraia, P. Pellegrini, E. Massenti, G-P. Ibba Chair of Clinical Oncology and Regional Cancer Hospital, Cadiari, Italy. High-dose medroxyprogesteroneacetate treatment is one of the most effective hormonal therapy in some endocrine-relatedtumors, giving a response rate of about 35% in pts. with disseminated breast cancer. Despite high dosage MPA is generally well tolerated, quite often it induces peculiar side-effects.Aim of this study was to evaluate some metabolic and cardiovascular effects. 63 pts. were evaluated (44 advanced breast cancer 10 kidney, 4 ovary, 3 prostate and 2 endometrial cancer) treated with NPA (29 pts.)or MPA+chemotherapy (34 pts.). MPA/os : 4200 mg/week; MPA/i.m. : 1000 mgfweek. The observed results are : GLICEMIA BODY WEIGHT SYSTOLIC BL.PKESS. DIASTOLIC BL.PHESS. +4 02% ~0.25 ;l;,;;; ~0.10 +9,63% p 0.005 +13,76% p 0.005 Ei+CHEMO +li,S% ~0.10 + 5 96% p 0.02 +4 85% p 0.02 noimai bPtoi5glucosi level increased i: 7/63 pts (11 1% ~OF~~~FeLeE~'4'pr~~tgXs:%) with pre-existing mild diabetes showed increased hyp&rgl!cemia. Systolic blood pressure significantly increased in 9163 pts.(14,28%; p 0.0005). From these preliminary data we can conclude that HD-MPA interferes on carbohydrate metabolism (probably due to MPA cortisonic metabolites, increase of appetite and bodyweight) and on arterial blood pressure (probably due to fluid and Na retention and a possible cathecolamines "permissive" activity of MPA cortisol-like effect. Therefore, patients at risk for metabolic and/or cardiovascular disease on MPA treatment have to be strictly monitorized.

273

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274 High-Dose Medroxyprogesterone Acetate (MPA) in Metastatic Cancer Patients G. Sturm, K.-D. Schulz, 11. J. Kiinzig, M. Wunsch P. Schmidt-Rhode, Klin. Philipps-Univ. Marburg, Pilgrimstein 3, 3550 Marburg I, PKG. Therapeutic effects of high dose medroxyprogesterone acetate (MPA) were evaluated in patients with disseminated cancer of the breast, corpus

uteri and ovary. Daily doses applicated orally and/or intramuscularly were 500, 900, 1200 mg. The study reports data on tumor response as well as side effects, as assessed by clinical investigation, x-ray and laboratory analysis. The main aspect of the examination is the trial to correlate tumor regression and MPA plasma concentrations measured by radioimmunoassay (RIA) or gas chromatographic techniques. Additional investigations of MPA effects on plasma levels of proteohormones (LH, FSH, ACTH, prolactin) and steroid hormones (estrogens, corticosteroids) and on tumor markers, such as CEA, TPA, R-HCG and PP lo are in progress.