A group of 213 unselected postmenopausal women with advanced breast cancer were treated with aminoglutethimide, 250 mg 4 times a day, and hydrocortisone, 20 mg 2 times a day. Follow-up is 10 months to 4 years from the start of treatment. In 190 assessable patients, there were 6 complete responses (CR), 47 partial responses (PR), 25 stable disease (SD), and 3 mixed responses. Overall objective response rate was 28% and with SD was 41%. Median duration of objective response was 14 months. Objective response by site was: soft tissue, 31%; nodes, 27%; bone 23%; liver, 22%; and lung, 16%. A further 32% of patients with bone deposits had SD, and 19 of 60 patients with progressive disease had pain relief.
Years after menopause, age and tumor-free interval did not affect response rates. Thirty-eight % of patients responding to previous endocrine therapy responded to aminoglutethimide compared with 19% of patients who had progressed on previous endocrine therapy.
A group of 213 patients were assessable for toxicity. Main side effects were drowsiness (33%), rash (23%), and nausea (15%). Eleven patients stopped treatment because of toxicity.
Median survival from start of treatment was 28 months for PR-CR and for SD and 10 months for progressive disease (p < 0.001). Median survival from first metastasis was 43 months for R-CR, 40 months for SD (not significantly different), and 22 months for progressive disease (p < 0.001).
Aminoglutethimide is an effective endocrine therapy in advanced postmenopausal breast cancer, particularly for bone deposits. Disease stabilization is associated with symptomatic and survival benefit similar to CR-PR.
Presented at the Conference “Aromatase: New Perspectives for Breast Cancer,” December 6 to 9, 1981, Key Biscayne, Fla.