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Lack of correlations between plasma concentration of medroxyprogesterone acetate, hypothalamic-pituitary function, and tumour response in patients with advanced breast cancer

  • Original Articles
  • Medroxyprogesterone, Breast Cancer
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Summary

Plasma medroxyprogesterone acetate (MPA) concentrations were measured in 61 patients with advanced breast cancer, after 3 weeks' treatment using 200 mg PO 8-hourly, to determine whether the previously reported wide interpatient variations correlated with tumour response or toxicity. Seventeen patients (28%) responded to the drug, and their mean plasma MPA concentration was 97 ng/ml ±68 SD, compared with 115 ng/ml ±87 SD for the patients whose disease progressed. Side-effects attributed to MPA were seen in 18 patients, who had a mean drug concentration of 113 ng/ml±104 SD. This was not significantly higher than that of the patients who did not experience drug toxicity.

Because of a suggestion that some of the antitumour activity of the drug could be mediated via an effect on the hypothalamic-pituitary axis, we also measured plasma FSG, LH, and prolactin concentrations after the 3-week treatment with MPA, but found no correlations with either drug concentration or tumour response. These results indicate that with the present treatment schedule the monitoring of plasma MPA concentrations has no role in routine practice and suggest that the inherent sensitivity of the tumour to progesterone is probably the major determinant of response.

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References

  1. Blossey HC, Bartsch HH, Kanne D, Koebberling J, Nagel GA (1982) The pharmacokinetics of high-dose medroxyprogesterone acetate (MPA) in the therapy of advanced breast cancer. Cancer Chemother Pharmacol 8:77–81

    Google Scholar 

  2. Camaggi CM, Strocchi E, Giovannini M, Angelelli B, Costanti B, Zebini E, Ferrari P, Pannuti F (1983) Medroxyprogesterone acetate (MPA) plasma levels after multiple high-dose administration in advanced cancer patients. Cancer Chemother Pharmacol 11:19–22

    Google Scholar 

  3. Cooperative Breast Cancer Study group (1969) Clinical trial of testololactone, medroxyprogesterone acetate and oxylone acetate in advanced female breast cancer. Cancer 23:109–112

    Google Scholar 

  4. DeLena M, Brambilla C, Valagussa P, Bonadonna G (1979) High-dose medroxyprogesterone acetate in breast cancer resistant to endocrine and cytotoxic therapy. Cancer Chemother Pharmacol 2:175–180

    Google Scholar 

  5. Haywood JL, Rubens RD, Carbone PP, Heuson J-C, Kaumaoka S, Segaloff A (1978) Assessment of response to therapy in advanced breast cancer. Eur J Cancer 14:1291–1292

    Google Scholar 

  6. Hedley D, Dalgleish A, Raghavan D, Tattersall M, Coates A, Fox R (1984) Advanced breast cancer: response to high-dose oral medroxyprogesterone acetate. Aust NZ J Med 14:251–254

    Google Scholar 

  7. Hesselius I, Johansson EDB (1981) Medroxyprogesterone acetate (MPA) plasma levels after oral and intramuscular administration in a long-term study. Acta Obstet Gynecol Scand [Suppl] 101:65–70

    Google Scholar 

  8. Izuo M, Iino Y, Tominaga Y, Nomura O, Abe K, Enomoto K, Takatani O, Kubo K (1982) Oral high-dose medroxyprogesterone acetate therapy in advanced breast cancer: clinical and endocrine studies. In: Proceedings of the International Symposium on Medroxyprogesterone Acetate. Excerpta Medica, Amsterdam, pp 250–263

    Google Scholar 

  9. Mattson W (1980) A phase III trial of treatment with tamoxifen versus treatment with high dose medroxyprogesterone acetate in advanced postmenopausal breast cancer. In: Iacobelli S, DiMarco A (eds) Role of medroxyprogesterone in endocrine-related tumors. Raven, New York, pp 65–71

    Google Scholar 

  10. Pannuti F, Martoni A, Lenaz GR, Piana E, Nanni P (1978) A possible new approach to the treatment of advanced breast cancer: massive doses of medroxyprogesterone acetate. Cancer Treat Rep 62:499–504

    Google Scholar 

  11. Pannuti F, Camaggi CM, Strocchi E, Giovannini M, Di Marco AR, Constanti B (1982) Medroxyprogesterone acetate (MAP) relative bioavailability after single high-dose administration in cancer patients. Cancer Treat Rep 66:2043–2049

    Google Scholar 

  12. Rautio A, Sotaniemi EA, Pelkonen RO, Luoma PV (1980) Treatment of alcoholic cirrhosis with enzyme inducers. Clin Pharmacol Ther 28:629–647

    Google Scholar 

  13. Robustelli Della Cuna G, Bernado-Strada MR, Garzina F (1982) High-dose medroxyprogesterone acetate in metastatic breast cancer. A critical review. In: Proceedings of the International Symposium on Medroxyprogesterone Acetate. Excerpta Medica, Amsterdam, pp 290–305

    Google Scholar 

  14. Saarni HV, Stengard J, Karki NT, Sotaniemi EA (1983) Medroxyprogesterone acetate improvement of the hepatic drug-metabolizing enzyme system in rats after chemical liver injury. Biochem Pharmacol 32:1075–1081

    Google Scholar 

  15. Sala G, Iannotta F, Facchinetti A (1982) Endocrinological properties of medroxyprogesterone acetate. In: Proceedings of the International Symposium on Medroxyprogesterone Acetate. Excerpta Medica, Amsterdam, pp 125–138

    Google Scholar 

  16. Salimtschik M, Mouridsen H, Loeber J, Johansson E (1980) Comparative pharmacokinetics of medroxyprogesterone acetate administered by oral and intramuscular routes. Cancer Chemother Pharmacol 4:267–269

    Google Scholar 

  17. Shrimanker K, Saxena BN, Fotherby K (1978) A radioimmunoassay for serum medroxyprogesterone acetate. J Steroid Biochem 9:359–363

    Google Scholar 

  18. Stoll BA (1967) Progestin therapy of breast cancer: comparison of agents. Br Med J III:338–341

    Google Scholar 

  19. Tamassia V, Battaglia A, Ganzina F, Isetta AM, Sacchetti G, Cavalli F, Goldhirsch A, Brunner K, Bernardo G, Robustelli Della Cuna G (1982) Pharmacokinetic approach to the selection of dose schedules for medroxyprogesterone acetate in clinical oncology. Cancer Chemother Pharmacol 8:151–156

    Google Scholar 

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Author notes

  1. Macdonald Christie

    Present address: University Department of Medicine, Austin Hospital, 3084, Heidelberg, Victoria, Australia

Authors and Affiliations

  1. Ludwig Institute for Cancer Research (Sydney Branch), University of Sydney, Blackburn Building, 2006, Sydney, N.S.W., Australia

    David W. Hedley

  2. Department of Pharmacology, University of Sydney, 2006, Sydney, N.S.W., Australia

    Macdonald Christie & Robert P. Weatherby

  3. Department of Endocrinology, Royal Prince Alfred Hospital, Missenden Road, 2050, Camperdown, N.S.W., Australia

    Ian D. Caterson

Authors
  1. David W. Hedley
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  2. Macdonald Christie
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  3. Robert P. Weatherby
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  4. Ian D. Caterson
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Hedley, D.W., Christie, M., Weatherby, R.P. et al. Lack of correlations between plasma concentration of medroxyprogesterone acetate, hypothalamic-pituitary function, and tumour response in patients with advanced breast cancer. Cancer Chemother. Pharmacol. 14, 112–115 (1985). https://doi.org/10.1007/BF00434347

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  • DOI: https://doi.org/10.1007/BF00434347

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