Abstract
Twenty-six patients with metastatic breast cancer who had previously responded to one or more endocrine therapies participated in a clinical trial of the combination of trilostane and hydrocortisone for subsequent disease progression. Of these, one patient achieved complete remission (4%), and five had partial response (19%). The median time to progression from initiation of therapy for responding patients was six months (range: 4 − 32 + months). Major toxicities included nausea/vomiting (16 patients), facial flushing (14), abdominal cramping (11), and oral paresthesia (10). Therapy was discontinued in four patients (15%) because of drug intolerance.
Fourteen patients who failed trilostane were treated with aminoglutethimide and hydrocortisone. Six patients showed objective response (PR + MR).
These data show that trilostane and hydrocortisone in combination can produce an objective response in a significant fraction of patients and that the combination has a different spectrum of toxicity from aminoglutethimide/hydrocortisone. A small number of patients crossed over to aminoglutethimide showed a few objective responses, suggesting a partial lack of cross-resistance between the two antiadrenal drugs.
References
Potts GO, Creange JE, Harding HR,et al.: Trilostane, an orally active inhibitor of steroid biosynthesis. Steroids 32: 257–260, 1978
Harvey HA, Demers LM, Santen RJ,et al.: The endocrine effects of trilostane therapy in metastatic breast cancer. Proceedings of the American Association of Clinical Research 27: 221, 1986 (abstr 875)
Beardwell CB, Hindley AC, Wilkinson PM,et al.: Hormonal changes in postmenopausal women with trilostane and dexamethasone. Clin Endocrinol 23: 413–421, 1985
Beardwell CB, Hindley AC, Wilkinson PM,et al.: Trilostane in the treatment of advanced breast cancer. Cancer Chemother Pharmacol 10: 158–160, 1983
Williams CJ, Barley V, Blackledge G,et al.: Multicenter study of trilostane. A new hormonal agent in advanced postmenopausal breast cancer. Cancer Treat Rep 71: 1197–1201, 1987
Williamson PM, Hindley AC, Beardwell CB,et al.: Trilostane, a new hormonal agent in the treatment of metastatic breast cancer. Proceedings of the American Society of Clinical Oncology 3: 113, 1984 (abstr C-442)
Harvey HA, Lipton A, Santen RJ,et al.: Medical adrenalectomy with trilostane and hydrocortisone in metastatic breast cancer. Proceedings of the American Society of Clinical Oncology 5: 69, 1986 (abstr 269)
Hayward JL, Carbone PP, Henson JC,et al.: Assessment of response to therapy in advanced breast cancer. Cancer 39: 1289–1294, 1977
Coombes RC, Powles TJ, Muindi J,et al. Trilostane therapy for advanced breast cancer. Cancer Treat Rep 69: 351–354, 1985
Henderson IC, Canellos VP: Cancer of the breast, the past decade. N Engl J Med 302: 17–30, 1980
Santen RJ, Samojlik E, Lipton A,et al.: Kinetic, hormonal, and clinical studies with aminoglutethimide in breast cancer. Cancer 39: 2948–2958, 1977
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Chu, P.S., Buzdar, A.U. & Hortobagyi, G.N. Trilostane with hydrocortisone in treatment of metastatic breast cancer. Breast Cancer Res Tr 13, 117–121 (1989). https://doi.org/10.1007/BF01806523
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DOI: https://doi.org/10.1007/BF01806523