Quality of life in postmenopausal patients with breast cancer after failure of tamoxifen: Formestane versus megestrol acetate as second-line hormonaltreatment

The Swiss Group for Clinical Cancer Research (SAKK) compared efficacy and t oxicity of formestane (250 mg intramuscularly (i.m.) every 2 weeks) versus megestrol acetate (MGA; 160 mg orally daily) as second-line treatment in po stmenopausal patients with advanced breast cancer and disease progression w hile on tamoxifen treatment in a randomised trial (Thurlimann B, Castiglion e M, Hsu Schmitz SF, et al. Eur J Cancer 1997, 33, 1017-1024), Quality of l ife (QL) was evaluated as a secondary endpoint (n = 177). Overall, 83% (669 /805) of expected QL forms were received, 88% (155/177) at baseline, 88% (4 02/457) on study treatment, and 65% (112/171) at treatment failure. Patient s with no impairment in performance status reported better physical well-be ing (P=0.0001), mood (P=0.0007) and coping (P=0.03), and less tiredness (P= 0.0001) and appetite/sense of taste disturbance (P=0.0001) at baseline. Aft er adjustment for baseline, there was no statistically significant differen ce in QL by treatment. Baseline QL was strongly predictive for QL under tre atment but not for time to treatment failure. In conclusion, the question o f whether oestrogen deprivation (e.g. formestane) or addition of progestero ne (MGA) has a more beneficial impact on QL needs further investigation. Th e subjective experience of second-line endocrine treatment varies considera bly as a consequence of the large variation in the individual course of the disease and has to be judged on an individual basis. (C) 1999 Elsevier Sci ence Ltd. All rights reserved.