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Tamoxifen in refractory metastatic carcinoma of the prostate
Abstract:
Thirty-one patients with advanced metastatic carcinoma of the prostate were treated with the antiestrogen tamoxifen. Of these patients, 29 were refractory to prior hormonal manipulation with estrogens and/or orchiectomy and five achieved an objective response (partial regression of stable disease using National Prostatic Cancer Project criteria). Median survival of the responders was significantly longer than that of the nonresponders (P < 0.05). Two additional patients who had not previously received hormonal therapy both responded, for an overall response rate of 23% (seven of 31 patients). Toxicity was minimal and no tumor flares were reported. These preliminary results support the further clinical trial of tamoxifen in advanced cancer of the prostate.
Insights
Tamoxifen, an antiestrogen, showed a 23% response rate in advanced prostate cancer patients, including those resistant to other therapies. Responders experienced significantly longer survival, with minimal toxicity, warranting further clinical trials.
Area of Science:
- Oncology
- Endocrinology
Background:
- Advanced metastatic prostate cancer often becomes refractory to standard hormonal therapies.
- Estrogen therapy and orchiectomy are common but may not be effective long-term.
Purpose of the Study:
- To evaluate the efficacy and toxicity of tamoxifen, an antiestrogen, in patients with advanced metastatic prostate cancer.
- To determine the response rate and survival outcomes in patients treated with tamoxifen.
Main Methods:
- Thirty-one patients with advanced metastatic prostate cancer were enrolled.
- Patients received the antiestrogen tamoxifen.
- Objective response was assessed using National Prostatic Cancer Project criteria.
Main Results:
- An overall response rate of 23% (seven of 31 patients) was observed.
- Five of 29 patients refractory to prior hormonal manipulation achieved an objective response.
- Median survival was significantly longer in responders compared to non-responders (P < 0.05).
- Two treatment-naive patients also responded to tamoxifen.
- Toxicity was minimal, with no reported tumor flares.
Conclusions:
- Tamoxifen demonstrates preliminary efficacy in advanced metastatic prostate cancer, including in hormone-refractory cases.
- The observed response rate and improved survival in responders suggest tamoxifen's potential therapeutic value.
- Further clinical trials of tamoxifen for advanced prostate cancer are warranted due to its efficacy and low toxicity profile.