The pharmacokinetics of high-dose medroxyprogesterone acetate (MPA) in the therapy of advanced breast cancer
Original Articles Medroxyprogesterone Acetate
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Summary
Oral MPA 1.5 g/day leads to plasma concentrations between 1 and 12 μg/ml, with a broad intra-and interindividual variance. The plateau state is reached in between 4 and 16 days. Plasma concentrations in the plateau state are very sensitive to dose modifications. After cessation of administration, the decline in plasma levels seems to proceed in two phases, with half-times of about 20 h and 4 days. Extraction procedures reveal no benefit in discriminating between MPA and its metabolites.
Keywords
Breast Cancer Acetate Plasma Concentration Cancer Research Plasma Level
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References
- 1.Adlercreutz H, Martin F, Järvenpää P, Fotsis T (1979) Steroid absorption and enterohepatic recycling. Contraception 2:201–223Google Scholar
- 2.Bartsch H-H, Bastert G, Blossey HC, Douwes FR, Firusian N, Hauswaldt C, Illiger HJ, Johanning U, Kleeberg UR, Nagel GA, Schierle U, Schreml W, Wander HE (to be published) AIO-Studie M 1/79: Mitomycin C and high dose medroxyprogesteronacetate in the treatment of advanced breast cancer. Verhandlungen der deutschen KrebsgesellschaftGoogle Scholar
- 3.Besch PK, Vorys H, Ullery JC, Barry RD, Couri D (1966) In vivo metabolism of H3-medroxyprogesterone acetate in pregnant and nonpregnant women and in the fetus. Am J Obstet Gynecol 95:228–238Google Scholar
- 4.Blossey HC, Bartsch HH, Köbberling J (1980) Binding characteristics of medroxyprogesterone acetate to steroid receptors in human mamma carcinoma. J Clin Chem Clin Biochem 18:729–730Google Scholar
- 5.Blossey HC, Bartsch HH, Köbberling J (1981) Die mögliche klinische Bedeutung des Androgenrezeptors in Mammacarcinomen. In: Maas H, Jonat W (eds) Steroidhormonrezeptoren im Carcinomgewebe. F. Enke VerlagGoogle Scholar
- 6.Blossey HC, Bartsch HH, Köbberling J Nagel GA (to be published) High-dose medroxyprogesterone acetate treatment: plasma levels and endocrine related effects. Verhandlungen der deutschen KrebsgesellschaftGoogle Scholar
- 7.Castegnaro E, Sala G (1962) Isolation and identification of 6, 17, 21-trihydroxy-6-methyl-4-pregnene-3,20-dione (21-acetate) from the urine of human subjects treated with 6-methyl-17-acetoxyprogesterone. J Endocrinol 24:445–452Google Scholar
- 8.Castegnaro E, Sala G (1971) Pharmacokinetics and metabolism of medroxyprogesterone acetate. Influence of the route of administration and of its physical state. Steroidologia 2:13–26Google Scholar
- 9.Cornette JC, Kirton KT, Duncan GW (1971) Measurement of medroxyprogesterone acetate (Provera) by radioimmunoassay. J Clin Endocrinol 33:459–466Google Scholar
- 10.De Lena M, Brambilla C, Valagussa P, Bonadonna G (1979) High-dose medroxyprogesterone acetate in breast cancer resistant to endocrine and cytotoxic therapy. Cancer Chemother Pharmacol 2:175–180Google Scholar
- 11.Duax WL, Cody V, Griffin J, Hazel J, Weeks CM (1978) Steroid structure and function. II. Conformational transmission and receptor binding of medroxyprogesterone acetate. J Steroid Biochem 9:901–907Google Scholar
- 12.Fukushima DK, Levin J, Liang JS et al. (1979) Isolation and partial synthesis of a new metabolite of medroxyprogesterone acetate. Steroids 34:57–72Google Scholar
- 13.Glenn EM, Richardson SL, Bowman BJ (1959) Biologic activity of 6-alpha-methyl compounds corresponding to progesterone, 17-alpha-hydroxyprogesterone acetate and compound S. Metabolism 8:265–285Google Scholar
- 14.Helmreich ML, Huseby RA (1962) Identification of a 6,21-dihydroxylated metabolite of medroxyprogesterone acetate in human urine. J Clin Endocrinol Metab 22:1018–1032Google Scholar
- 15.Helmreich ML, Huseby RA (1965) Factors influencing the absorption of medroxyprogesterone acetate. Steroids [Suppl] II:79–95Google Scholar
- 16.Hiroi M, Stanczyk FZ, Goebelsmann U, Brenner PF, Lumkin ME, Mishel DR Jr (1975) Radioimmunoassay of serum medroxyprogesterone acetate (Provera) in women following oral and intravaginal administration. Steroids 26:373–386Google Scholar
- 17.Jeppsson S, Johansson EDB (1976) Medroxyprogesterone acetate, estradiol, FSH and LH in peripheral blood after intramuscular administration of depo-Provera to women. Contraception 14:461–469Google Scholar
- 18.Kaiser DG, Carlson RG, Kirton KT (1974) DLC determination of medroxyprogesterone acetate in plasma. J Pharm Sci 63:420–424Google Scholar
- 19.Laatikainen T, Nieminen U, Adlercreutz H (1979) Plasma medroxyprogesterone acetate levels following intramuscular of oral administration in patients with endometrial adenocarcinoma. Acta Obstet Gynecol Scand 58:95–99Google Scholar
- 20.Mattsson W (1978) High-dose medroxyprogesterone-acetate treatment in advanced mammary carcinoma. A phase II investigation. Acta Radiol Oncol 17:387–406Google Scholar
- 21.Ortiz A, Hiroi M, Stanczyk FZ, Goebelsmann U, Mishell DR Jr (1977) Serum medroxyprogesterone acetate (MPA) concentrations and ovarian function following intramuscular injection of Depo-MPA. J Clin Endocrinol Metab 44:32–38Google Scholar
- 22.Pannuti F (1977) Moderne prospettive nel trattamento del cancero della mammella e delle sue metastasi. Minerva Chir 32:1–10Google Scholar
- 23.Pannuti F (1979) Die hochdosierte Gestagenbehandlung in der Therapie des fortgeschrittenen Mammakarzinoms. Onkologie 2:54–60Google Scholar
- 24.Pannuti F, Martoni A, Pollutri E, Camera P, Lenaz GR (1974) Medroxyprogesterone acetate (MAP): Effects of massive doses in advanced breast cancer. IRCS 2:1605Google Scholar
- 25.Pannuti F, Fruet F, Cricca A (1977a) Pilot trial of the use of massive doses of medroxyprogesterone acetate (MAP) orally in oncology. IRCS Med Sci 5: 433Google Scholar
- 26.Pannuti F, Martoni A, Piana E (1977b) Higher doses of medroxyprogesterone acetate in the treatment of advanced breast cancer. IRCS Med Sci 5:54Google Scholar
- 27.Robustelli Della Cuna G, Calciati A, Strada MRB, Bumma C, Campio L (1978) High-dose medroxyprogesterone acetate (MPA) treatment in metastatic carcinoma of the breast: A dose-response evaluation. Tumori 64:143–149Google Scholar
- 28.Royer ME, Ko A, Campbell JA, Murray HC, Evans JS, Kaitter DG (1974) RIA for MPA (Provera) using the 11α-hydroxysuccinate conjugates. Steroids 23:713–730Google Scholar
- 29.Sala G, Castegnaro E (1964) Biotransformation of 21-methyl into 21-methoxyl steroids. In: Pasqualini JR, Jayle MF (eds) Structure and metabolism of corticosteroids. Academic Press, London New York, pp 95–102Google Scholar
- 30.Sala G, Castegnaro E, Lenaz GR, Martoni A, Piana E, Pannuti F (1978)_Hormone interference in metastatic breast cancer patients treated with medroxyprogesterone acetate at massive doses: Preliminary results. IRCS Med Sci 6:129Google Scholar
- 31.Salimtschik M, Mouridsen HT, Loeber J, Johansson E (1980) Comparative pharmacokinetics of medroxyprogesterone acetate administered by oral and intramuscular routes. Cancer Chemother Pharmacol 4:267–269Google Scholar
- 32.Sall S, Disaia P, Morrow CP, Mortel R, Prem K, Thigpen T, Greasman W (1979) A comparison of medroxyprogesterone serum concentrations by the oral or intramuscular route in patients with persistent or recurrent endometrial carcinoma. Am J Obstet Gynecol 135:647–650Google Scholar
- 33.Schwalli PC (1974) Experience with Depo-Provera as in injectable contraceptive. J Reprod Med 13:113–117Google Scholar
- 34.Shrimanker K, Saxena BN, Fotherby K (1978) A radioimmunoassay for serum medroxyprogesterone acetate. J Steroid Biochem 9:359–363Google Scholar
- 35.Slaunwhite WR, Sandberg AA (1964) Disposition of radioactive 17α-hydroxyprogesterone, 6α-methyl-17α-acetony-progesterone and 6α-methylprednisolone in human subjects. J Clin Endocrinol Metab 21:753–764Google Scholar
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