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Published in: International Journal of Clinical Oncology 1/2015

01-02-2015 | Original Article

Estramustine phosphate sodium in heavily pretreated patients with metastatic breast cancer: a retrospective consecutive case series

Authors: Gaetano Aurilio, Rossella Graffeo, Vincenzo Bagnardi, Franco Nolè, Laura Adamoli, Olivia Pagani, Elisa Gallerani, Benvenuto Ferrari, Giancarlo Pruneri, Aron Goldhirsch

Published in: International Journal of Clinical Oncology | Issue 1/2015

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Abstract

Background

Estramustine phosphate sodium (EMP) is an oral agent poorly developed—although active—in patients with metastatic breast cancer (MBC). To resume interest in EMP in MBC, we analyzed a retrospective series of consecutive patients with estrogen receptor-positive disease.

Methods

EMP was given orally at a dose of 140 mg daily. Treatment discontinuation rates due to progressive disease/toxicity and response rates were assessed.

Results

Twenty postmenopausal patients with mainly visceral disease were treated with EMP, in five cases in combination with other anticancer drugs. Median numbers of previous chemotherapies and hormonal treatments were six and four, respectively. From the entire cohort, one complete response and four partial responses were observed. The proportions of patients free of progression at 6 and 12 months were 39 and 8 %, respectively. Six patients discontinued EMP, three each for toxicity and adverse events.

Conclusion

Good disease control was obtained in heavily pretreated MBC patients receiving EMP. Toxicity was manageable and reversible although treatment discontinuation has to be considered. A prospective study should be encouraged to identify the optimal use of the drug.
Literature
1.
go back to reference Forsberg JG, Hoisaeter PA (1975) Effects of hormone-cytostatic complexes on the rat ventral prostate in vivo and in vitro. Vitam Horm 33:137–154PubMedCrossRef Forsberg JG, Hoisaeter PA (1975) Effects of hormone-cytostatic complexes on the rat ventral prostate in vivo and in vitro. Vitam Horm 33:137–154PubMedCrossRef
3.
go back to reference Fredholm B, Jensen G, Lindskog M et al (1974) Effects of estramustine phosphate on growth of DMBA-induced mammary tumours in rats. Acta Pharmacol Toxicol (suppl I) 35:28 Fredholm B, Jensen G, Lindskog M et al (1974) Effects of estramustine phosphate on growth of DMBA-induced mammary tumours in rats. Acta Pharmacol Toxicol (suppl I) 35:28
4.
go back to reference Forshell GP, Nilsson H (1974) The distribution of radioactivity after administration of labeled estramustine phosphate (Estracyt), Estracyt-17-phosphate and estradiol to rats (suppl 1). Acta Pharmacol Toxicol 15:28 Forshell GP, Nilsson H (1974) The distribution of radioactivity after administration of labeled estramustine phosphate (Estracyt), Estracyt-17-phosphate and estradiol to rats (suppl 1). Acta Pharmacol Toxicol 15:28
5.
go back to reference Jönsson G, Högberg B (1971) Treatment of advanced prostatic carcinoma with Estracyt. A preliminary report. Scand J Urol Nephrol 5(2):103–107PubMedCrossRef Jönsson G, Högberg B (1971) Treatment of advanced prostatic carcinoma with Estracyt. A preliminary report. Scand J Urol Nephrol 5(2):103–107PubMedCrossRef
6.
go back to reference Fernö M, Borg A, Idvall I (1987) Estramustine binding site in human breast cancer biopsy samples. Its relation to estrogen and progesterone receptor levels, age and menopausal status. Eur J Cancer Clin Oncol 23:1505–1510PubMedCrossRef Fernö M, Borg A, Idvall I (1987) Estramustine binding site in human breast cancer biopsy samples. Its relation to estrogen and progesterone receptor levels, age and menopausal status. Eur J Cancer Clin Oncol 23:1505–1510PubMedCrossRef
7.
go back to reference Alexander NC, Hancock AK, Masood MB et al (1979) Estracyt in advanced carcinoma of the breast: a phase II study. Clin Radiol 30:139–147PubMedCrossRef Alexander NC, Hancock AK, Masood MB et al (1979) Estracyt in advanced carcinoma of the breast: a phase II study. Clin Radiol 30:139–147PubMedCrossRef
8.
go back to reference Dawes PJ (1982) A pilot study of Estracyt in advanced breast cancer. Cancer Treat Rep 66:581–582PubMed Dawes PJ (1982) A pilot study of Estracyt in advanced breast cancer. Cancer Treat Rep 66:581–582PubMed
9.
go back to reference Wada T, Morikawa E, Houjou T et al (1990) Clinical evaluation of estramustine phosphate in the treatment of patients with advanced breast cancers. Gan To Kagaku Ryoho 17(9):1901–1904PubMed Wada T, Morikawa E, Houjou T et al (1990) Clinical evaluation of estramustine phosphate in the treatment of patients with advanced breast cancers. Gan To Kagaku Ryoho 17(9):1901–1904PubMed
10.
go back to reference Zelek L, Barthier S, Riofrio M et al (2001) Single-agent estramustine phosphate (EMP) is active in advanced breast cancer after failure with anthracyclines and taxanes. Ann Oncol 12:1265–1268PubMedCrossRef Zelek L, Barthier S, Riofrio M et al (2001) Single-agent estramustine phosphate (EMP) is active in advanced breast cancer after failure with anthracyclines and taxanes. Ann Oncol 12:1265–1268PubMedCrossRef
11.
go back to reference Tiersten AD, Nelsen C, Talbot S et al (2003) A phase II trial of docetaxel and estramustine in patients with refractory metastatic breast carcinoma. Cancer 97:537–544PubMedCrossRef Tiersten AD, Nelsen C, Talbot S et al (2003) A phase II trial of docetaxel and estramustine in patients with refractory metastatic breast carcinoma. Cancer 97:537–544PubMedCrossRef
12.
go back to reference Ellis MJ, Gao F, Dehdashti F et al (2009) Lower-dose vs high-dose oral estradiol therapy of hormone receptor-positive, aromatase inhibitor-resistant advanced breast cancer: a phase 2 randomized study. JAMA 302(7):774–780PubMedCentralPubMedCrossRef Ellis MJ, Gao F, Dehdashti F et al (2009) Lower-dose vs high-dose oral estradiol therapy of hormone receptor-positive, aromatase inhibitor-resistant advanced breast cancer: a phase 2 randomized study. JAMA 302(7):774–780PubMedCentralPubMedCrossRef
Metadata
Title
Estramustine phosphate sodium in heavily pretreated patients with metastatic breast cancer: a retrospective consecutive case series
Authors
Gaetano Aurilio
Rossella Graffeo
Vincenzo Bagnardi
Franco Nolè
Laura Adamoli
Olivia Pagani
Elisa Gallerani
Benvenuto Ferrari
Giancarlo Pruneri
Aron Goldhirsch
Publication date
01-02-2015
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 1/2015
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-014-0694-2

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