E. Merkle et al., SEQUENCE-THERAPY AND INTERVAL THERAPY IN METASTATIC BREAST-CANCER WITH TAMOXIFEN AND MPA, Tumordiagnostik & Therapie, 15(3), 1994, pp. 104-108
In a prospective randomized study at the Department of Obstetrics and
Gynaecology, University of Erlangen-Nuremberg, 86 patients with metast
atic breast cancer and positive or unknown steroid hormone receptor st
atus were refered to different hormone therapy schemes. One group of p
atients (N = 44) received a sequence therapy with 30 mg of Tamoxifen d
aily. In case fo relaps after original response the therapy was change
d to MPA. The second group of patients (N = 42) received 30 mg/die Tam
oxifen for 4 weeks. After a wash out period of 4 weeks, during which t
he patients had no medication, a therapy with 1000 mg/die MPA followed
. After a therapeutic pause of one week the scheme was started again.
Both therapy schemes showed no significant difference concerning the r
esponse rate (86 % in the sequence therapy - and 79 % in the interval
therapy group). With regard to the response rate the interval therapy
compared with the sequence therapy showed an advantage with respect to
the lower absolute dosage used in these patients. Concerning the resp
onse duration the sequence therapy was significantly superior to the i
nterval therapy (32 versus 21 months response duration). Particularly
remarkable is the difference in patients with complete remission, whic
h had a median response duration of 47 months in the sequence therapy
group compared with only 24 months in the interval therapy group. It s
hould be noticed, that sequence therapy patients suffered further recu
rrence before the therapeutic change from Tamoxifen to MPA. In contras
t to this the response duration of the interval therapy refers to a si
ngle hormone therapy with Tamoxifen and MPA alternately, without a cha
nge of therapy due to a recurrence. Side-effects were minimal in both
therapeutic schemes. Inspite of similar response rates the sequence th
erapy with its longer response duration seems to be superior ot the in
terval therapy, also with respect to the easier intake mode.