RESUMEN
Twenty-eight patients with metastatic renal cell carcinoma entered a multicentric prospective study to evaluate the response to high-dose medroxyprogesterone acetate (MPA) and testosterone in MPA failures in relation to sex steroid receptors. No objective remission was seen in the 24 evaluable patients, and only disease stabilizations of short duration were achieved in one-third of treated patients. Stabilizations achieved with second line testosterone were all seen in patients unresponsive to MPA. Receptor studies demonstrated that estrogen, progesterone, or androgen receptors were found in low concentrations and in only 6 of 23 tumors (26%) and 13 normal tissue samples (56%). Surprisingly, no disease stabilization was achieved in patients positive for receptors. It can be concluded that the occasional objective responses to hormone therapy reported in the literature may have been due to some cytotoxic effect of hormone therapy rather than to a true hormonal mechanism.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Neoplasias Renales/tratamiento farmacológico , Receptores de Superficie Celular/efectos de los fármacos , Adulto , Anciano , Femenino , Humanos , Masculino , Medroxiprogesterona/administración & dosificación , Medroxiprogesterona/análogos & derivados , Acetato de Medroxiprogesterona , Persona de Mediana Edad , Metástasis de la Neoplasia , Nefrectomía , Estudios Prospectivos , Receptores Androgénicos/efectos de los fármacos , Receptores de Estrógenos/efectos de los fármacos , Receptores de Progesterona/efectos de los fármacos , Testosterona/administración & dosificaciónRESUMEN
From July 1979 to December 1981, 83 patients from 6 centers in the Lombardy underwent radical nephrectomy for category M0 renal cell carcinoma. Postoperatively they were randomly allocated to adjunctive medroxyprogesterone acetate (MPA) or to a control group. After the first year of follow-up, the relapse rate was 13% in the controls (5 of 38 evaluable patients) versus 28% in the MPA treatment group (9 of 32). Sex steroid receptors were studied in both the tumor and in the surrounding healthy parenchyma by the dextran-coated charcoal technique in 52 of 70 clinically evaluable patients. There was no significant correlation between receptor studies and the relapse rate. Besides, receptors were more often detected in the healthy than in the neoplastic tissue, and values rarely exceeded 10 fmol/mg protein. Due to the negative trend in the MPA treatment group, the admittance of patients to this study was stopped after 120 patients had been accepted.