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Megestrol acetate in relapsed carcinoma of prostate
F Daniel1, P M MacLeod, C J Tyrrell
1Department of Radiotherapy and Oncology, Plymouth General Hospital.
Abstract:
A series of 22 patients with advanced carcinoma of the prostate who had failed first-line hormonal therapy (orchiectomy, stilboestrol, luteinising hormone-releasing hormone agonist) were treated with 160 mg megestrol acetate daily. Treatment was well tolerated, side effects were minimal and 21 patients were evaluable. There were no complete or partial responses, although 8 patients had a good subjective response. In 6 patients the disease was stabilised for 6 to 12 months and there was a 40 to 50% reduction in their prostatic acid phosphatase (PAP) levels. It was concluded that megestrol acetate has a role as second-line hormonal therapy in the management of prostatic carcinoma.
Insights
Megestrol acetate offers a tolerable option for advanced prostate cancer patients resistant to initial treatments. This second-line hormonal therapy showed disease stabilization and reduced prostatic acid phosphatase levels in some patients.
Area of Science:
- Oncology
- Urology
- Endocrinology
Background:
- Advanced prostate cancer often becomes resistant to first-line hormonal therapies.
- Identifying effective second-line treatments is crucial for managing treatment-refractory disease.
Purpose of the Study:
- To evaluate the efficacy and tolerability of megestrol acetate as a second-line hormonal therapy for advanced prostate carcinoma.
- To assess treatment response, side effects, and impact on prostatic acid phosphatase (PAP) levels.
Main Methods:
- A cohort of 22 patients with advanced prostate cancer, who had failed prior hormonal treatments, received 160 mg of megestrol acetate daily.
- Patient outcomes, including subjective response, disease stabilization, and PAP levels, were monitored.
Main Results:
- Treatment was well-tolerated with minimal side effects in 21 evaluable patients.
- No complete or partial responses were observed, but 8 patients reported good subjective improvement.
- Six patients achieved disease stabilization for 6-12 months, with a 40-50% reduction in PAP levels.
Conclusions:
- Megestrol acetate demonstrates a role as a second-line hormonal therapy option for advanced prostate cancer.
- It can provide subjective benefits and disease stabilization in patients progressing on standard hormonal treatments.