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  • 1
    ISSN: 1573-7217
    Keywords: estrogen receptor ; antiestrogen ; tamoxifen ; chemotherapy ; immunotherapy ; stage II breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective, randomized clinical trial of adjuvant treatment of 318 stage II breast cancer patients, using chemotherapy, the antiestrogen tamoxifen, and immunotherapy is reported at 48 months follow-up. Women whose primary tumors have no estrogen receptors fall into a significantly poorer prognostic group than those whose tumors contain estrogen receptors. None of the adjuvant regimens appeared to offer any clear-cut advantage for the estrogen receptor negative patients. Those women whose primary tumor contains estrogen receptors appear to be in a prognostically favorable group, when their treatment regimen included the antiestrogen, tamoxifen. The adjuvant use of BCG immunotherapy does not appear to offer additional benefit, but the follow-up period of these treated patients is too brief to be conclusive. A longer period of observation is needed to determine whether this systemic treatment in estrogen receptor positive patients is preventing recurrence or merely delaying it.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7217
    Keywords: androgen-dependent tumor ; Shionogi tumor ; adjuvant chemo-endocrine therapy ; adjuvant endocrine therapy ; adjuvant chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary About 500 male DS mice grafted with androgen-dependent Shionogi carcinoma 115 (SC115) were used. When the tumor diameter reached about 20 mm (approximately 25 days after transplantation), excision of the tumor and/or castration were carried out. The injection of cyclophosphamide (80 mg/kg body weight × 3 at 7-day intervals) was started from the day after excision. In mice with excised tumor, adjuvant chemo-endocrine therapy was the most effective treatment examined; cumulative 120-day mortalities after transplantation of tumors in non-treated, adjuvant endocrine therapy, adjuvant chemotherapy and adjuvant chemo-endocrine therapy groups were 91%, 29%, 21% and 0%, respectively. Castration induced development of clusters of androgen-independent cancer cells in androgendependent SC115 tumor. In mice without tumor excision, the chemo-endocrine therapy was again the most effective treatment, though 86% of mice died by the 120th day after tumor transplantation. These findings suggest the usefulness of adjuvant chemo-endocrine therapy for achieving complete remission in hormonedependent tumors.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7217
    Keywords: adrenalectomy ; aminoglutethimide ; breast cancer tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fifty-three women with actively progressing advanced breast cancer, who had all previously received tamoxifen, were treated with aminoglutethimide to induce medical adrenalectomy. Sixty-nine percent of the patients who had previously responded to tamoxifen subsequently responded to aminoglutethimide, while thirty-five percent of the nonresponders to tamoxifen subsequently responded to aminoglutethimide. The median duration of remission to aminoglutethimide was 12 months with a range from 4 to 22 + months. The drug was well tolerated and would appear to be the treatment of choice in tamoxifen responsive cases of advanced breast cancer.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 1 (1981), S. 105-109 
    ISSN: 1573-7217
    Keywords: breast cancer ; endocrine therapy ; chemotherapy ; DMBA-induced mammary tumors ; combination therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of a combination of endocrine and chemical therapies has been studied during the past decade in DMBA-induced rat mammary tumors and advanced human breast cancers. Although interferential effects have been observed between endocrine therapy and chemotherapy in highly hormone-dependent tumors or cell lines, beneficial effects can be achieved from a combination of these two treatment modalities in human breast cancer when the steroid receptor status and the presence or absence of visceral metastases are considered in the selection of treatment programs.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7217
    Keywords: antiestrogen ; hypophysectomy ; androgens ; chemotherapy ; sequential ; survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Follow-up data of 113 patients with stage IV breast cancer treated with the antiestrogen tamoxifen show that the duration of remission is in average in excess of 21 months with a median of 16 months. Survival from start of antiestrogen therapy was significantly longer in patients who responded to tamoxifen, in those with dominant site of disease in the soft tissue, and in those with less extensive metastatic involvement. Overall survival from onset of metastasis was also much longer in patients who had responded to tamoxifen than in those who had failed (median of 52 and a half months vs 23 months). Hypophysectomy and androgen therapy used sequentially after antiestrogen each induced further remissions in almost half of the patients with a median duration of 16 months and 10 months respectively. Five drug chemotherapy used in most patients after maximum benefit had been obtained with endocrine therapy induced remissions in two-thirds of the patients with a median duration of 8 months. Adriamycin used sequentially as a single agent induced significant further palliation in almost half of the patients with a median duration of 4 and a half months. We conclude that sequential endocrine therapy and chemotherapy is highly effective in the treatment of stage IV breast cancer and offers prolonged survival to patients with hormone responsive tumors.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 1 (1981), S. 121-123 
    ISSN: 1573-7217
    Keywords: hormone therapy ; cell kinetics ; chemotherapy ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Results of treatment for advanced breast cancer have plateaued indicating the need for new treatment approaches. One such approach, combined endocrine therapy and cytotoxic chemotherapy, has had limited success in current clinical trials. This lack of synergism could be due to the effect of endocrine therapy on tumor cell kinetics, which could inhibit the activity of the cytotoxic drug. Proper sequencing of the two treatment modalities may increase the therapeutic ratio.
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  • 7
    ISSN: 1573-7217
    Keywords: medroxyprogesterone acetate (MAP) ; oral high-dose ; hormone therapy ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Medroxyprogesterone acetate (MAP) in the treatment of advanced breast cancer has been regarded as a minor agent according to the previous reports when used at low doses (〈500 mg/day). High doses of more than 500 mg which have come into use since 1973 give a response rate of over 40%, but sometimes cause gluteal abcess or induration because of daily intramuscular injections. In order to administer easily and to avoid the side effect, we have attempted to use oral administration in a daily dose of 1200mg (400 mg × 3). Of those 20 patients treated with oral high-dose MAP, 1 showed complete response, 6 showed partial response, 7 no change, and 6 progressive disease. As for site of lesion, 4 out of 6 (67%) in skin and 4 out of 16 (25%) in bone responded. Neither severe side effects nor abnormal laboratory data were seen. Then, we examined the blood levels of MAP in vivo by RIA in 9 patients. The blood level of MAP reached 39–250 ng/ml in 3 days and was maintained at least over 50 ng/ml for 1 or 2 months of continuous administration. Subsequently, we examined the effects of MAP on binding to ER in vitro. The inhibition of binding of estradiol-17β to ER was about 60% at 10−5 M MAP. The blood level of 50 ng/ml in vivo corresponds to about 1.3 × 10−5 M.
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  • 8
    ISSN: 1573-7217
    Keywords: estrogen receptor ; prognosis ; adjuvant therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The estrogen receptor (ER) assay provides information which correlates with the proliferative potential, pathology and prognosis for patients with breast cancer. A review of our natural history data correlating ER and axillary node involvement at the time of mastectomy with prognosis allows the identification of a high risk subset of patients with early recurrence and poor survival. Patients with ER negative, stage II disease had a significantly higher recurrence rate, and poorer overall survival was observed in spite of systemic therapy instituted at relapse. Based on this data we initiated a pilot study of intensive adjuvant therapy for women with ER negative, stage II breast cancer. At a median follow-up of 19 months for 39 treated patients, both a disease free and overall survival advantage is apparent for treated patients. Morbidity was low, with no therapy related hospitalizations. We have demonstrated the feasibility of intensive therapy for this high risk group. For a definitive answer the patient resources of a cooperative group will be needed.
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  • 9
    ISSN: 1573-7217
    Keywords: breast cancer ; chemohormonal therapy ; fluoxymesterone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From October 1973 to October 1977 the ECOG prospectively evaluated cyclophosphamide, methotrexate, and fluorouracil (CMF) versus CMF plus fluoxymesterone (CMFH) maintenance therapies in responders to 6 months of induction therapy which consisted of either CMF, CMF plus prednisone (CMFP), or adriamycin plus vincristine (AV). Following the maintenance randomization 12% of the patients converted from a PR to a CR status. The median time from randomization to treatment failure was 9.5 months for CMFH and 6.7 months for CMF (p = 0.03). This difference was observed only for partial responders (p = 0.01) and not for complete responders. Patients receiving CMFH tended to maintain higher hemoglobin, leukocyte, and platelet levels, and receive a higher dosage of each of the cytotoxic drugs. The results are taken as evidence that the addition of fluoxymesterone to a maintenance CMF regimen provides a therapeutic advantage. It is hypothesized that this effect is due at least in part to fluoxymesterone associated maintenance of improved marrow function resulting in greater myelosuppressive drug delivery.
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  • 10
    ISSN: 1573-7217
    Keywords: breast cancer ; clinical trials ; consensus report ; operative management ; segmental mastectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Information available from NSABP protocols has contributed to an altered biological perception of breast cancer. The results of these studies lend support to a hypothesis which postulates that alterations in the loco-regional treatment of primary breast cancer will not change the natural history of the disease relative to distant metastasis and survivorship. Data from NSABP Protocol B-04 indicate that radical mastectomy provides no advantage over total mastectomy in clinically node-negative patients. Since 39% of this population had histologically positive nodes it may be concluded that leaving histologically positive nodes untreated results in no disadvantage. NSABP Protocol B-04 made available the scientific rationale for the study of breast-preserving operations in which the clinical significance of multicentricity will be determined. Although there is a sound scientific basis for the consideration of segmental mastectomy, there are no data available to justify the utilization of the procedure outside the context of a clinical trial. With the increased popularity and implementation of breast-preserving operations without the necessary supporting data, a potentially dangerous situation has been created which threatens to undermine the clinical trial process.
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