Role of Medroxyprogesterone in Endocrine-Related Tumors 3 [antikvár]

Preface During the 1970s, progress in the treatment of hormone-related tumors began to level off, as measured by response rate, response duration, and overall survival; in particular, the treatment of breast cancer showed this disappointing "plateau" effect, and treatment strategy remains controversial. Therefore, contributions leading to a deeper knowledge of the pathophysiology and treatment of these hormone-related tumors are of great value to the clinical oncologist. This volume focuses on the role of medroxyprogesterone acetate (MPA) in the treatment of such tumors. MPA is an old drug, administered in the early 1960s to patients with advanced breast cancer in so-called low doses, with relatively disappointing results; then, in the early 1970s, the Bologna group rediscovered MPA as a "new" drug in so-called high doses, with suggestive results in the treatment of breast, endometrial, and prostatic cancer. MPA represents a real weapon against these tumors, equally as important as antiestrogens, antiandrogens, and amino-glutethimide in a global treatment strategy; none of these drugs precludes the use of the others; on the contrary, it may be possible to improve our therapeutic results by utilizing some combination. Knowledge of MPA specific activity, receptor and hormone interactions, pharmacokinetics, and side effects has improved significantly but some undeniable problems having pharmacological, clinical, ethical, and economic aspects remain. Having established that MPA yields approximately a 40% median response rate in unselected patients and approximately 55% in subjects whose receptor status was assessed, researchers still face some basic problems. First, considering the response rate, MPA plasma levels, overall survival, quality of life, and undesirable side effects, what is the optimal dose and which administration route is preferable? To answer these questions, one must consider the dose-response relationship and the patient's quality of life.