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Effects of Long-Term Administration of Tamoxifen on Steroid Metabolism in Prostatic Carcinoma Patients
ONCOLOGY AND CHEMOTHERAPY
Although the age-incidence pattern for prostatic carcinoma is exponential it also is atypical in shape. This could indicate an unusual role for aging in prostatic cancer incidence, or an unusual problem in collecting that incidence data. The authors described quantitatively the shape of the typical cancer ageincidence patterns and the magnitude of atypical behavior exhibited by prostatic cancer. The pattern for prostatic cancer was atypical, less than 99 per cent confidence limits from the mean at ages less than 60 years and greater than the 99 per cent confidence limits from the mean at ages greater than 75 years. The available international data on latent carcinoma of the prostate, when normalized, resembled the mean male and female cancer pattern in Connecticut, and suggested that atypical behavior of prostatic cancer resulted from the lag between the incidence of latent carcinoma and promotion to clinical stage. Confirmation of this suggestion, with the potential to distinguish epidemiologically those latent carcinomas that remain asymptomatic from those that progress to malignancy, awaits routine screening for the latent carcinoma. N. V. R. 2 figures, 2 tables, 29 references
compare the efficacy of intermittent versus continuous treatment with estramustine phosphate. The continuous treatment regimen consisted of 2 capsules (560 mg.) twice daily for as long as a response was maintained. With the intermittent regimen the patients received the same dosage for an initial period of 2 months, then a 2-month interval free of drugs followed by 1 month on treatment in sequence. Of 95 randomized patients 77 could be evaluated (46 with continuous and 31 with intermittent therapy). Remissions were seen in 13 patients (28 per cent) on continuous and 13 per cent on intermittent therapy. There was no statistically significant difference between stable disease (65 per cent for continuous versus 77 per cent for intermittent therapy groups) and rates of progression (6 and 10 per cent, respectively). Therapy was discontinued in 19 per cent of the patients owing to intolerable gastrointestinal side effects (7 receiving continuous and 8 receiving intermittent therapy). The development of gynecomastia seemed to be high despite preventive mammary irradiation before the initiation of therapy. This study shows that continuous as well as intermittent therapy is sufficient to control prostatic cancer. F. T. A.
3 figures, 3 tables, 14 references
Effects of Long-Term Administration of Tamoxifen on Steroid Metabolism in Prostatic Carcinoma Patients N. J. BOLTON, P. VIHKO, P. LEINONEN, M. KONTTURI AND R. VIHKO, Departments of Clinical Chemistry and Surgery, Uni-
versity of Oulu, Oulu, Finland Prostate, 6: 417-422, 1985 The use of the antiestrogen tamoxifen is established in the treatment of breast carcinoma, including that in male patients. It is believed to act by competing with estrogen for binding sites and it also has some estrogen-like effects. The results of early studies and case reports suggest that tamoxifen might be useful in the treatment of prostatic carcinoma. The authors treated 6 patients with advanced prostatic carcinoma with 20 mg. tamoxifen twice daily for up to 3 months before orchiectomy. The results of their study on steroids in the peripheral serum, testicular tissue and spermatic vein serum show that long-term treatment does not lead to eventually decreased androgenic effect in prostatic carcinoma patients. The clinical results also were unfavorable in all of the patients, which indicated no direct effect of tamoxifen on prostatic tissue. Three patients later had a positive response to orchiectomy but the other 3 did not, which indicated that they had a hormone independent disease. Over-all, the results showed that tamoxifen at a dose of 20 mg. twice daily for up to 3 months was ineffective irrespective of whether the disease was hormone dependent. N. V. R. 3 tables, 25 references Comparison Between Continuous and Intermittent Administration of Estracyt in the Treatment of Carcinoma of the Prostate W. VAHLENSIECK, G. WEGNER, H.-D. LEHMANN, G. FRANZEN, L. STEFFENS ANDS. WAHLBY, Departments of Urology, Uni-
versity Hospital, Bonn, and Cologne-Holweide Hospital and St. Antonius Hospital, Eschweiler, Federal Republic of Germany and Medical Department, Research Laboratories, AB Leo, Helsingborg, Sweden
Treatment of Prostatic Carcinoma With D-Trp-6-LHRH: Plasma Hormone Levels After Daily Subcutaneous Injections and Periodic Administration of Delayed-Release Preparations M. ROGER, J. DUCHIER, N. LAHLOU, K. NAHOUL AND A. V.
Fondation de Recherche en Hormonologie and Therapharm-Recherches, Paris, France, and Veterans Administration Medical Center and Tulane University School of Medicine, New Orleans, Louisiana SCHALLY,
Prostate, 7: 271-282, 1985 Prolonged sustained administration of luteinizing hormonereleasing hormone leads to desensitization of gonadotropins produced by the pituitary gland and down-regulates the receptors. This phenomenon can be used to suppress the secretion of follicle-stimulating and luteinizing hormones, leading to decreased gonadal activities. Luteinizing hormone-releasing hormone may be synthesized chemically in the laboratory. The synthesized agonists are more potent and used to treat prostatic cancer, endometriosis, premenopausal breast cancer and precocious puberty. The authors studied the effects of a delayed release form of luteinizing hormone-releasing hormone (D-Trp6 luteinizing hormone-releasing hormone) in 13 men with prostatic cancer. The efficacy of various regimens of luteinizing hormone-releasing hormone was studied by determining the serum levels of follicle-stimulating and luteinizing hormones, and testosterone, 17-hydroxyprogesterone and estradiol. The data support the notion that periodic administration of D-Trp6 luteinizing hormone-releasing hormone causes suppression of testicular secretions. N. J. 6 figures, 36 references Relationships Between Estrogen Intake, Serum Testosterone, and Tumor Androgen, Estrogen, and Progesterone Receptor Levels in Diethylstilbestrol-Treated Rats Bearing the R3327 Prostatic Adenocarcinoma G. MOBBS AND I. E. JOHNSON, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
Urol. Res., 13: 209-212 (Sept.) 1985
B.
From 1976 to 1982, 95 patients with carcinoma of the prostate (stages A to D and all histological grades) were randomized to
Prostate, 7: 293-304, 1985
Although the age-incidence pattern for prostatic carcinoma is exponential it also is atypical in shape. This could indicate an unusual role for aging in prostatic cancer incidence, or an unusual problem in collecting that incidence data. The authors described quantitatively the shape of the typical cancer ageincidence patterns and the magnitude of atypical behavior exhibited by prostatic cancer. The pattern for prostatic cancer was atypical, less than 99 per cent confidence limits from the mean at ages less than 60 years and greater than the 99 per cent confidence limits from the mean at ages greater than 75 years. The available international data on latent carcinoma of the prostate, when normalized, resembled the mean male and female cancer pattern in Connecticut, and suggested that atypical behavior of prostatic cancer resulted from the lag between the incidence of latent carcinoma and promotion to clinical stage. Confirmation of this suggestion, with the potential to distinguish epidemiologically those latent carcinomas that remain asymptomatic from those that progress to malignancy, awaits routine screening for the latent carcinoma. N. V. R. 2 figures, 2 tables, 29 references
compare the efficacy of intermittent versus continuous treatment with estramustine phosphate. The continuous treatment regimen consisted of 2 capsules (560 mg.) twice daily for as long as a response was maintained. With the intermittent regimen the patients received the same dosage for an initial period of 2 months, then a 2-month interval free of drugs followed by 1 month on treatment in sequence. Of 95 randomized patients 77 could be evaluated (46 with continuous and 31 with intermittent therapy). Remissions were seen in 13 patients (28 per cent) on continuous and 13 per cent on intermittent therapy. There was no statistically significant difference between stable disease (65 per cent for continuous versus 77 per cent for intermittent therapy groups) and rates of progression (6 and 10 per cent, respectively). Therapy was discontinued in 19 per cent of the patients owing to intolerable gastrointestinal side effects (7 receiving continuous and 8 receiving intermittent therapy). The development of gynecomastia seemed to be high despite preventive mammary irradiation before the initiation of therapy. This study shows that continuous as well as intermittent therapy is sufficient to control prostatic cancer. F. T. A.
3 figures, 3 tables, 14 references
Effects of Long-Term Administration of Tamoxifen on Steroid Metabolism in Prostatic Carcinoma Patients N. J. BOLTON, P. VIHKO, P. LEINONEN, M. KONTTURI AND R. VIHKO, Departments of Clinical Chemistry and Surgery, Uni-
versity of Oulu, Oulu, Finland Prostate, 6: 417-422, 1985 The use of the antiestrogen tamoxifen is established in the treatment of breast carcinoma, including that in male patients. It is believed to act by competing with estrogen for binding sites and it also has some estrogen-like effects. The results of early studies and case reports suggest that tamoxifen might be useful in the treatment of prostatic carcinoma. The authors treated 6 patients with advanced prostatic carcinoma with 20 mg. tamoxifen twice daily for up to 3 months before orchiectomy. The results of their study on steroids in the peripheral serum, testicular tissue and spermatic vein serum show that long-term treatment does not lead to eventually decreased androgenic effect in prostatic carcinoma patients. The clinical results also were unfavorable in all of the patients, which indicated no direct effect of tamoxifen on prostatic tissue. Three patients later had a positive response to orchiectomy but the other 3 did not, which indicated that they had a hormone independent disease. Over-all, the results showed that tamoxifen at a dose of 20 mg. twice daily for up to 3 months was ineffective irrespective of whether the disease was hormone dependent. N. V. R. 3 tables, 25 references Comparison Between Continuous and Intermittent Administration of Estracyt in the Treatment of Carcinoma of the Prostate W. VAHLENSIECK, G. WEGNER, H.-D. LEHMANN, G. FRANZEN, L. STEFFENS ANDS. WAHLBY, Departments of Urology, Uni-
versity Hospital, Bonn, and Cologne-Holweide Hospital and St. Antonius Hospital, Eschweiler, Federal Republic of Germany and Medical Department, Research Laboratories, AB Leo, Helsingborg, Sweden
Treatment of Prostatic Carcinoma With D-Trp-6-LHRH: Plasma Hormone Levels After Daily Subcutaneous Injections and Periodic Administration of Delayed-Release Preparations M. ROGER, J. DUCHIER, N. LAHLOU, K. NAHOUL AND A. V.
Fondation de Recherche en Hormonologie and Therapharm-Recherches, Paris, France, and Veterans Administration Medical Center and Tulane University School of Medicine, New Orleans, Louisiana SCHALLY,
Prostate, 7: 271-282, 1985 Prolonged sustained administration of luteinizing hormonereleasing hormone leads to desensitization of gonadotropins produced by the pituitary gland and down-regulates the receptors. This phenomenon can be used to suppress the secretion of follicle-stimulating and luteinizing hormones, leading to decreased gonadal activities. Luteinizing hormone-releasing hormone may be synthesized chemically in the laboratory. The synthesized agonists are more potent and used to treat prostatic cancer, endometriosis, premenopausal breast cancer and precocious puberty. The authors studied the effects of a delayed release form of luteinizing hormone-releasing hormone (D-Trp6 luteinizing hormone-releasing hormone) in 13 men with prostatic cancer. The efficacy of various regimens of luteinizing hormone-releasing hormone was studied by determining the serum levels of follicle-stimulating and luteinizing hormones, and testosterone, 17-hydroxyprogesterone and estradiol. The data support the notion that periodic administration of D-Trp6 luteinizing hormone-releasing hormone causes suppression of testicular secretions. N. J. 6 figures, 36 references Relationships Between Estrogen Intake, Serum Testosterone, and Tumor Androgen, Estrogen, and Progesterone Receptor Levels in Diethylstilbestrol-Treated Rats Bearing the R3327 Prostatic Adenocarcinoma G. MOBBS AND I. E. JOHNSON, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
Urol. Res., 13: 209-212 (Sept.) 1985
B.
From 1976 to 1982, 95 patients with carcinoma of the prostate (stages A to D and all histological grades) were randomized to
Prostate, 7: 293-304, 1985