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Tamoxifen and megestrol acetate for postmenopausal breast cancer

Diverging effects on liver proteins, androgens, and glucocorticoids

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Abstract

Aim: To compare the effects of tamoxifen and megestrol acetate on liver proteins, androgens, and glucocorticoids during adjuvant treatment for postmenopausal breast cancer.

Methods: A subgroup of women within a large prospective multicenter trial were followed with blood sampling every 3 mo during 2 yr. Women were randomized to receive either continuous tamoxifen 40 mg/d or repeated sequential treatment with tamoxifen and megestrol acetate (MA) 160 mg/d.

Results: We found profound and distinct differences between the two regimens. Tamoxifen increased steroid-binding proteins (SHBG and CBG) and suppressed circulating androgens and IGF-I. In contrast, the metabolic effects of tamoxifen were clearly antagonized by MA. There was a rise in IGF-I and marked suppression of steroid-binding proteins. Levels of free testosterone were reduced by 70%. MA also caused apparent adrenal suppression.

Conclusion: The different effects on anabolic/catabolic balance and adrenal function may relate to certain clinical effects during treatment.

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Authors and Affiliations

  1. Department of Surgery, St Görans Hospital, SE-112 81, Stockholm, Sweden

    L. Löfgren

  2. Department of Oncology, Radiumhemmet, Karolinska Hospital, SE-171 76, Stockholm, Sweden

    B. Wallberg, N. Wilking & E. von Schoultz

  3. Department of Oncology, Huddinge University Hospital, SE-141 86, Stockholm, Sweden

    T. Fornander & L. E. Rutqvist

  4. Department of Obstetrics and Gynecology, Huddinge University Hospital, SE-141 86, Stockholm, Sweden

    K. Carlström

  5. Department of Obstetrics and Gynecology, Karolinska Hospital, SE-171 76, Stockholm, Sweden

    B. von Schoultz

Authors
  1. L. Löfgren
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  2. B. Wallberg
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  3. N. Wilking
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  4. T. Fornander
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  5. L. E. Rutqvist
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  6. K. Carlström
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  7. B. von Schoultz
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  8. E. von Schoultz
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Correspondence to L. Löfgren.

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Löfgren, L., Wallberg, B., Wilking, N. et al. Tamoxifen and megestrol acetate for postmenopausal breast cancer. Med Oncol 21, 309–318 (2004). https://doi.org/10.1385/MO:21:4:309

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  • DOI: https://doi.org/10.1385/MO:21:4:309

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