Tamoxifen versus high-dose oral medroxyprogesterone acetate as initial endocrine therapy for patients with metastatic breast cancer: a Piedmont Oncology Association study.

• DOI: 10.1200/jco.1994.12.8.1630
• Publication Date: 2017-02-23T13:06:03Z
• Authors: H B Muss; L D Case; J N Atkins; J D Bearden; M R Cooper; J M Cruz; D V Jackson; M A O'Rourke; M D Pavy; B L Powell
• Keywords: Regimen

To determine in a prospective randomized trial whether high-dose orally administered medroxy-progesterone acetate (MPA) was superior to tamoxifen patients with recurrent or metastatic breast cancer who had received no prior endocrine therapy either the adjuvant advanced setting.Patients initially 20 mg/d MPA 1 g/d orally. At time of disease progression, were crossed over other regimen. Eligibility required be age > = 18 years, performance status 0 3, and estrogen receptor (ER)- progesterone (PR)-positive unknown.One hundred eighty-two eligible entered 166 assessable for response. Complete plus partial response rates 17% 34%, respectively (P .01). Patients bone metastases significantly higher rate compared (33% v 13%). Median treatment failure 5.5 months 6.3 .48). The median survival duration 24 33 .09). Multivariate analysis showed that influenced rate, but not survival. After following MPA, six 42 (14%) treated responded, 49 (12%) tamoxifen. Both agents associated minimal toxicity, 35% on gained more than lb as opposed only 2% tamoxifen.In this trial, initial endocrine-naive improvement survival, when Further trials are warranted if progestin is these patients.