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Breast Cancer Research and Treatment

, Volume 148, Issue 1, pp 73–80 | Cite as

Antiandrogen therapy in metastatic male breast cancer: results from an updated analysis in an expanded case series

  • Luigi Di Lauro
  • Patrizia Vici
  • Maddalena Barba
  • Laura Pizzuti
  • Domenico Sergi
  • Massimo Rinaldi
  • Anna Di Benedetto
  • Isabella Sperduti
  • Abeer M. Shaaban
  • Valerie Speirs
  • Marcella Mottolese
  • Ruggero De Maria
  • Marcello Maugeri-SaccàEmail author
Clinical trial

Abstract

Male breast cancer is a rare disease treated as hormone receptor-positive female breast cancer. The characterization of breast cancer at the molecular level has lately revealed gender-related differences. As the androgen receptor is emerging as a potential oncogenic driver in male breast cancer, we analyzed efficacy data from metastatic patients treated with antiandrogens. We evaluated the activity of cyproterone acetate, either as a monotherapy or combined with a GnRH analog, in 36 metastatic male breast cancer patients. Fourteen patients were treated with cyproterone acetate as monotherapy and 22 patients with complete androgen blockade. We recorded 4 complete responses and 15 partial responses, for an overall response rate of 52.8 % (95 % CI, 36.5–69.4). Stable disease was reported in 11 patients. Median PFS was 8.9 months (95 % CI, 6.1–11.7), and median OS was 24.3 months (95 % CI, 22.5–26.1). Data on androgen receptor expression were available for 7 patients. All the 4 patients with androgen receptor-expressing tumors had a clinical benefit, including a patient with an estrogen receptor-negative disease. Conversely, none of the 3 patients with androgen receptor-negative tumors had a tumor response. Antiandrogen-based therapy showed efficacy in metastatic male breast cancer patients. Our results encourage considering antiandrogens in the therapeutic continuum, especially if supported by androgen receptor expression.

Keywords

Metastatic male breast cancer Antiandrogens Cyproterone acetate GnRH analogs Androgen receptor 

Notes

Acknowledgments

We thank Dr Tania Merlino for language revisions and Dr Ana Maria Edlisca for editorial assistance. We are also grateful to Prof Massimo Lopez for his critical appraisal and constructive suggestions.

Conflict of interest

The authors declare that they have no conflict of interest. Data included in the present study were partly presented at the 1999 ASCO Annual Meeting (abstract 415), Atlanta, GA, May 15–18.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Luigi Di Lauro
    • 1
  • Patrizia Vici
    • 1
  • Maddalena Barba
    • 1
    • 2
  • Laura Pizzuti
    • 1
  • Domenico Sergi
    • 1
  • Massimo Rinaldi
    • 1
  • Anna Di Benedetto
    • 3
  • Isabella Sperduti
    • 4
  • Abeer M. Shaaban
    • 5
  • Valerie Speirs
    • 6
  • Marcella Mottolese
    • 3
  • Ruggero De Maria
    • 2
  • Marcello Maugeri-Saccà
    • 1
    • 2
    Email author
  1. 1.Division of Medical Oncology B“Regina Elena” National Cancer InstituteRomeItaly
  2. 2.Scientific Direction“Regina Elena” National Cancer InstituteRomeItaly
  3. 3.Department of Pathology“Regina Elena” National Cancer InstituteRomeItaly
  4. 4.Biostatistics Unit“Regina Elena” National Cancer InstituteRomeItaly
  5. 5.Department of PathologyUniversity Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Queen Elizabeth Hospital, Queen Elizabeth Medical CentreBirminghamUK
  6. 6.Leeds Institute of Cancer and Pathology, Wellcome Trust Brenner BuildingUniversity of LeedsLeedsUK

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