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Combined antihormonal treatment with an LHRH agonist, aminoglutethimide and flutamide in advanced relapsing breast cancer
‘--&DGESTERDNE SUPPLEMENTATION IN INFERTILE PATIENTS WITH LUTEAL PHASE Gerhard, I., Kruse, W., Miedaner-Meyer, I., Runnrbeum, B. Department of Gynaecoiogical Women ‘s Hospital, University of Heidelberg; West Germany
DEFECTS: Endocrinology,
The effectiveness of progesterone (P) supplementation in infertile patients with luteal phase defects (LPO) is still contradictory. Therefore two different routes of P application were tested against placebo in a randomized double-blind fashion. During a 1.5-year study period 48 patients of a total of 308 patients were selected. They met the following criteria: proven tubal patency, normal semen analysis, positive postcoital test, and normal hormone concentrations (androgens, prolactin, TSH). The definition of LPD was: low serum P value (meenQOng/ml from three samples taken during the 5th and 10th hyperthermic day) and/or endometrial biopsy out of phase (taken two days before the expected menstruation). The women were randomly distributed to 4 treatment regimens: capsules containing 200 mg micronised progesterone (A n=15) or placebo (8 n=S), or vaginal suppositories containing 25 mg progesterone (C n=lO) or placebo (D ntll). The substance was taken twice daily from the 3rd to the 13th day p.o. Treatment was discontinued if serum O-HCG of the 12th postovulatory day was negative. Repeated endometrial biopsies and P determinations were performed in the third treatment cycle. An increase of serum P concentration was measured in 92% and 100% of the patients receiving A and C (22% B, 7% 0). An improvement of the endometrial pattern was found in less than 20% of the women (A 8%, 817 %, C 20%, D 0 %). No serious side effects were registered. Pregnancy rate during 3 months of treatment was low in all groups tested (A 1346, B 22%, C 20%, D 21%). There was no correlation between conception rate and type of LPD. Our preliminary data demonstrate that only few atients with signs of LPD may benefit increases the serum P from P supplementation therapy. The oral and vaginal route o P P administration concentrations (A significantly more than C) while the influence on the endometrium is less obvious.
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65 COMBINED ANTIHORMONAL TRBATMBNT WITHAN LHRHAGONIST, AMINOGLUTETHIMIDE AND FLJTAMIDE IN ADVANCED RELAPSINGBREASTCANCER.DuPont, A.; Labria, F.; Gigdre, M.; Borsanpi, J.P.; B&land, L.; Lacourcisre, Y.; Bergeron, V. Lava1 University Medical Center, QulZbec GlV 462, Canada. can play an important role Recent evidence strongly suggests that adrenal Cl94 5-steroids In breast cancer through thefr Interaction with estrogen and androgen receptors. In order to achieve further hormonal blockade, 25 advanced (stage IV) relapsing breast cancer patients received a combination treatment Mth the LHRHagonist [D-Trp6] LHRHethylamide, Flutamide, aminoglutethimide and hydrocortisone. The mean duration of treatment Is 272 days (28 to 557 days). Pain was Initially present in 89.3% of patients while an abnormal performance was recap dcd in 82.1% of them at the initiation of the combination therapy. Bone metastaecs alone were present in 52X, bone and liver metaotaaes In 16%. Serumdehydroepiandroaterone-aulfate (DEBAS) and DmA decrearcd by 90% of their initial level, while androstenedione and androat-5-ene3 6,17 Cdlol ware inhlbited by more than 50%. A positive objective response (assessed according to the criteria of the UICC) was observed in 20.8% of subjecto; two patients reachad a partial response and three were evaluated as no change while nineteen had progressive disease and one died from other causes than breast cancer before evaluation of response. Among the progressing patients, 3 displayed a mixed response, some leaions regresslng while others progressed. Although the study includes only twenty-five patients and is thus preliminary, it already indicates that a significant proportion of breast cancer tmore are still sensitive to a more efficient neutralization or blockade of ovarian and adrenal steroids. At the very advanced the ml1 tolerated combination therapy offers additional stage of disease of our patiants, benefits to a significant proportion of them after failure to all conventional treatments.
SUCCESSFUL TREATMENT OF J.UVENILE RHEUMATOID ARTHRITIS WITHOUT STEROIDS
T.Yamauchi, 1548 Akano,
Y .Yamauchi, Hazama-cho,
K.I!iura. Oita-gun,
A.Cooper, Cryo-Biological-Institute Oita, JAPAN
Through the administration of I’- 17O’C Whole Body Extreme Cold Treatment” the use of adrenocorticosteroids can be reduced and stopped in Juvenile Rheumatoid Arthritis patients. Patients less than 18 years were selected for this study. 20 patients I!aged 2-18 years) had suffered for 13-164 months. 1.25mg-50mg/day (mean ll.O3mg/day) steroid therapy had been administered prior to admission for 13-164 months (mean 68 months;. These 20 patients who had been unable to reduce or stop steroid therapy received “-;JO’C Whole Body Extreme Cold Treatment” twice daily. Of the 20 patients, 15 were on i.25-SOmg/day :5 stopped steroid therapy from 2-32 imean ll.45mg/day) corticosteroids. All ‘I-i JO*C Whole Body Extreme Cold months (mean 10.8 months) after starting Treatment”. 5 patients who received 5-20mg steroids/day (mean 1 i.2mgi have ‘I- I JO* C Whole reduced steroid therapy to 2.7mg/day over 10.9 months\meanl. Body Extreme Cold Treatment” is absolutely effective in reducing exogenous “-1JO’C Whole Body Extreme Cold Treatment” must become the corticosteroids. treatment of choice for JRA patients who would otherwise be commited to the unfortunate ravages of long-term corticosteroid therapy.
24s
DEFECTS: Endocrinology,
The effectiveness of progesterone (P) supplementation in infertile patients with luteal phase defects (LPO) is still contradictory. Therefore two different routes of P application were tested against placebo in a randomized double-blind fashion. During a 1.5-year study period 48 patients of a total of 308 patients were selected. They met the following criteria: proven tubal patency, normal semen analysis, positive postcoital test, and normal hormone concentrations (androgens, prolactin, TSH). The definition of LPD was: low serum P value (meenQOng/ml from three samples taken during the 5th and 10th hyperthermic day) and/or endometrial biopsy out of phase (taken two days before the expected menstruation). The women were randomly distributed to 4 treatment regimens: capsules containing 200 mg micronised progesterone (A n=15) or placebo (8 n=S), or vaginal suppositories containing 25 mg progesterone (C n=lO) or placebo (D ntll). The substance was taken twice daily from the 3rd to the 13th day p.o. Treatment was discontinued if serum O-HCG of the 12th postovulatory day was negative. Repeated endometrial biopsies and P determinations were performed in the third treatment cycle. An increase of serum P concentration was measured in 92% and 100% of the patients receiving A and C (22% B, 7% 0). An improvement of the endometrial pattern was found in less than 20% of the women (A 8%, 817 %, C 20%, D 0 %). No serious side effects were registered. Pregnancy rate during 3 months of treatment was low in all groups tested (A 1346, B 22%, C 20%, D 21%). There was no correlation between conception rate and type of LPD. Our preliminary data demonstrate that only few atients with signs of LPD may benefit increases the serum P from P supplementation therapy. The oral and vaginal route o P P administration concentrations (A significantly more than C) while the influence on the endometrium is less obvious.
-
65 COMBINED ANTIHORMONAL TRBATMBNT WITHAN LHRHAGONIST, AMINOGLUTETHIMIDE AND FLJTAMIDE IN ADVANCED RELAPSINGBREASTCANCER.DuPont, A.; Labria, F.; Gigdre, M.; Borsanpi, J.P.; B&land, L.; Lacourcisre, Y.; Bergeron, V. Lava1 University Medical Center, QulZbec GlV 462, Canada. can play an important role Recent evidence strongly suggests that adrenal Cl94 5-steroids In breast cancer through thefr Interaction with estrogen and androgen receptors. In order to achieve further hormonal blockade, 25 advanced (stage IV) relapsing breast cancer patients received a combination treatment Mth the LHRHagonist [D-Trp6] LHRHethylamide, Flutamide, aminoglutethimide and hydrocortisone. The mean duration of treatment Is 272 days (28 to 557 days). Pain was Initially present in 89.3% of patients while an abnormal performance was recap dcd in 82.1% of them at the initiation of the combination therapy. Bone metastaecs alone were present in 52X, bone and liver metaotaaes In 16%. Serumdehydroepiandroaterone-aulfate (DEBAS) and DmA decrearcd by 90% of their initial level, while androstenedione and androat-5-ene3 6,17 Cdlol ware inhlbited by more than 50%. A positive objective response (assessed according to the criteria of the UICC) was observed in 20.8% of subjecto; two patients reachad a partial response and three were evaluated as no change while nineteen had progressive disease and one died from other causes than breast cancer before evaluation of response. Among the progressing patients, 3 displayed a mixed response, some leaions regresslng while others progressed. Although the study includes only twenty-five patients and is thus preliminary, it already indicates that a significant proportion of breast cancer tmore are still sensitive to a more efficient neutralization or blockade of ovarian and adrenal steroids. At the very advanced the ml1 tolerated combination therapy offers additional stage of disease of our patiants, benefits to a significant proportion of them after failure to all conventional treatments.
SUCCESSFUL TREATMENT OF J.UVENILE RHEUMATOID ARTHRITIS WITHOUT STEROIDS
T.Yamauchi, 1548 Akano,
Y .Yamauchi, Hazama-cho,
K.I!iura. Oita-gun,
A.Cooper, Cryo-Biological-Institute Oita, JAPAN
Through the administration of I’- 17O’C Whole Body Extreme Cold Treatment” the use of adrenocorticosteroids can be reduced and stopped in Juvenile Rheumatoid Arthritis patients. Patients less than 18 years were selected for this study. 20 patients I!aged 2-18 years) had suffered for 13-164 months. 1.25mg-50mg/day (mean ll.O3mg/day) steroid therapy had been administered prior to admission for 13-164 months (mean 68 months;. These 20 patients who had been unable to reduce or stop steroid therapy received “-;JO’C Whole Body Extreme Cold Treatment” twice daily. Of the 20 patients, 15 were on i.25-SOmg/day :5 stopped steroid therapy from 2-32 imean ll.45mg/day) corticosteroids. All ‘I-i JO*C Whole Body Extreme Cold months (mean 10.8 months) after starting Treatment”. 5 patients who received 5-20mg steroids/day (mean 1 i.2mgi have ‘I- I JO* C Whole reduced steroid therapy to 2.7mg/day over 10.9 months\meanl. Body Extreme Cold Treatment” is absolutely effective in reducing exogenous “-1JO’C Whole Body Extreme Cold Treatment” must become the corticosteroids. treatment of choice for JRA patients who would otherwise be commited to the unfortunate ravages of long-term corticosteroid therapy.
24s