A New Endocrine Therapy Strategy for Bone Metastasis of Breast Cancer: The Effect of Biological Response Modifiers
1Department of Emergency and Critical Care Medicine, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi 371, Japan.
Abstract:
To consider the treatment order of hormonal agents is very important in order to achieve a higher quality of life (QOL) and better survival rates in breast cancer patients with bone metastasis. Tamoxifen (TAM) or a luteinizing hormone-releasing hormone (LH-RH )analogue is the first-line, an LH-RH analogue (or TAM) the second-line, and medroxyprogesterone acetate(MPA) the third-line treatment in premenopausal patients with breast cancer. In postmenopausal patients, TAM (or toremifene) is the first-line, an aromatase inhibitor the second-line, and MPA the third-line treatment. In experimental studies using female Sprague-Dawley rats with 7, 12-dimethylbenz ma]anthracene (DMBA)-induced mammary carcinoma, biological response modifiers (BRM)(Krestin, Picibanil) and a vitamin D3 analogue, 22-oxacarcitriol (OCT)augmented the antitumor effect of hormonal agents. A combination of hormonal agents and BRM or OCT may be the endocrine therapy of choice for bone metastasis of breast cancer.
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