Beneficial response to pituitary ablation following aminoglutethimide

Twenty-five postmenopausal women with advanced carcinoma of the breast, who were treated initially with aminoglutethimide alone (14 patients) or combined with tamoxifen (11 patients) had, on relapse or failure of treatment, a pituitary ablation performed. Initial therapy had produced a complete response in one patient, a partial response in 7, disease stasis in 6 but was without benefit in 8 patients. A further three patients were intolerant of aminoglutethimide therapy. Ten of these 25 patients benefited from subsequent pituitary ablation (1 complete response, 4 partial responses and 5 disease stasis), both local and distant sites of disease being influenced by this further therapy. Experience is also reported of 10 patients with advanced breast cancer who were treated initially by pituitary ablation and then subsequently received aminoglutethimide therapy. None responded. It is concluded that pituitary ablation should be considered for patients with progressive disease following aminoglutethimide therapy, irrespective of the therapeutic response to aminoglutethimide.