Tamoxifen and medroxyprogesterone therapy for advanced endometrial carcinoma

We have studied the response rates and survival of a group of 93 patients with Stage III or IV endometrial adenocarcinoma after random allocation to therapy with tamoxifen (TAM) 20 mg twice daily (n = 45) or medroxyprogesterone acetate (MPA) 1 g/wk intramuscularly (n = 48). The patients were examined every 4 months. In the non-responders and in those who relapsed, combination therapy with TAM and MPA was given. Twenty-four of 45 (53.4%) responded to TAM alone, 27 of 48 (56.2%) responded to MPA alone. Of the responders 23 later relapsed in the TAM group and 24 in the MPA group and of these 14 (60.8%) and 15 (62.5%), respectively, responded to the combination therapy. Of the original 21 non-responders to MPA alone, 10 responded to the combination (47.6%) and 11 (52.4%) did not; the comparable figures for the TAM alone group were 13 (61.9%) and 8 (38.1%), respectively. Survival rates were much higher in the differentiated than in the undifferentiated carcinomas. In conclusion, we feel that the efficacy, and the few side-effects of these drugs used alone and particularly when used in sequential combination, make them a very attractive treatment for advanced endometrial adenocarcinoma.