No abstract

No abstract

Eighty-nine patients with advanced ovarian cancer have been treated with a combination of cis-platinum (50 mg/m²) + an anthracycline (adriamycin 50 mg/m² in 26 patients, or epirubicin 60 mg/m² in 63 patients). The treatment was repeated every 28 days for a maximum of 12 cycles. Seventy-nine were evaluable for response. CR was achieved in 19 (24%) patients (2 clinical and 17 after a second-look evaluation) and a PR in 31 (39%) for an estimated median duration of 43 and 10 months, respectively. Nine patients who achieved CR and 2 out of 10 non-evaluable patients were alive without any evidence of disease after a median follow-up of 36 months (range 29–53). The treatment was generally well tolerated. The multivariate actuarial 4-year analysis by Cox’s proportional hazards model shows that residual tumor and performance status have an independent prognostic value on survival. The combination of CP + an anthracycline (and in particular epirubicin) is an effective and generally well tolerated treatment for ovarian cancer. Only patients with initial minimal residual disease and achieving CR are candidates for long-term survival.

Forty premenopausal patients with advanced breast cancer entered a prospective and randomized study in which high-dose medroyxprogesterone acetate (HD MAP) and oophorectomy (OPX) were compared. All the patients were first treated for advanced disease. Twenty-two patients received HD MAP (1,000 mg b.i.d. p.o.) and 18 patients received OPX. Complete remission (CR) was achieved in 2 (9%) in the HD MAP group and in 2 (11 %) in the OPX group for a duration of 20–24 and 30–54 months respectively. Partial remission (PR) was achieved in 10 (45%) patients in the HD MAP group and in 4 (22%) patients in the OPX group for a median duration of 9 and 7 months respectively. The objective response rates (CR + PR) were 55% for the HD MAP group and 33% for the OPX group (p = 0.17). Ten patients who received OPX as first-line treatment received HD MAP when the disease progressed and were evaluable for response: PR was achieved in 6 patients (2 responders and 4 nonresponders to OPX) for a median duration of 5 months. Two out of 4 patients who received OPX at progression after objective response to HD MAP presented PR. HD MAP induced a significant decrease in pain intensity and, compared to OPX, a more frequent improvement was induced in performance status. No difference was observed between the two groups in terms of overall survival. This study shows that HD MAP is an active treatment in premenopausal patients with advanced breast cancer and that it can induce a response in some patients resistant to OPX.

No abstract