Journal of Clinical Oncology, Vol 11, 1957-1968, Copyright © 1993 by American Society of Clinical Oncology
Hormonal palliation of chemoresistant ovarian cancer: three consecutive phase II trials of the Mid-Atlantic Oncology Program
JD Ahlgren, NM Ellison, RJ Gottlieb, F Laluna, JJ Lokich, PR Sinclair, W Ueno, GL Wampler, KY Yeung and D Alt
Division of Hematology/Oncology, George Washington University Medical Center, Washington, DC 20037.
PURPOSE: To evaluate the efficacy of three hormonal manipulations in the
palliation of chemoresistant ovarian cancer, and to analyze the results in
the light of other clinical trials. PATIENTS AND METHODS: Three sequential
phase II trials were performed in patients with refractory epithelial
ovarian carcinoma, using high-dose megestrol acetate (800 mg/d for 30 days,
then 400 mg/d), high-dose tamoxifen (80 mg/d for 30 days, then 40 mg/d),
and aminoglutethimide (1 g/d plus tapering doses of hydrocortisone).
Results were compared with those described in the world literature from
trials of the same or similar agents. RESULTS: No responses were seen among
30 assessable patients treated with megestrol acetate, and most (but not
all) similar trials have reported low response rates. Five responses (17%)
were seen among 29 patients treated with tamoxifen. Two responses exceeded
5 years in duration. No responses were seen among 15 patients treated with
aminoglutethimide. CONCLUSION: Antiestrogen therapy may offer the
possibility of useful and, occasionally, long-term palliation of refractory
epithelial ovarian carcinoma, with little toxicity. There may be a trend
toward a dose-response effect, which represents a suitable topic for a
future prospective trial.
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