Twenty-eight patients with metastatic renal cell carcinoma entered a multicentric prospective study to evaluate the response to high-dose medroxyprogesterone acetate (MPA) and testosterone in MPA failures in relation to sex steroid receptors. No objective remission was seen in the 24 evaluable patients, and only disease stabilizations of short duration were achieved in one-third of treated patients. Stabilizations achieved with second line testosterone were all seen in patients unresponsive to MPA. Receptor studies demonstrated that estrogen, progesterone, or androgen receptors were found in low concentrations and in only 6 of 23 tumors (26%) and 13 normal tissue samples (56%). Surprisingly, no disease stabilization was achieved in patients positive for receptors. It can be concluded that the occasional objective responses to hormone therapy reported in the literature may have been due to some cytotoxic effect of hormone therapy rather than to a true hormonal mechanism.
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References
1.
AlbertoP., SennH.J.: Hormonal therapy of renal carcinoma alone and in association with cystostatic drugs.Cancer, 35: 1226–1229, 1974.
2.
Al-SarafM., EyreH., BonnetJ., SaikiJ., GaglianoR., PughR., LehaneD., DixonD., BottomleyR.: Study of tamoxifen in metastatic renal cell carcinoma and influence of certain prognostic factors: A Southwest Oncology Group study.Cancer Treat. Rep., 65: 447–451, 1981.
3.
BloomH.J.G.: Medroxyprogesterone (Provera) in treatment of metastatic renal cancer.Br. J. Cancer, 25: 250–265, 1971.
4.
BloomH.J.G., DukesC.E., MicthleyB.C.V.: Hormone-dependent tumours of the kidney.I. The oestrogen-induced renal tumour of the syrian hamster. Hormone treatment and possible relationship to carcinoma of the kidney in man. Br. J. Cancer, 17: 511–645, 1963.
5.
BojarH., MaarK., StaibW.: The endocrine background of human renal cell carcinoma.I. Binding of the highly potent progestin R5020 by tumour cytosol. Urol. Int., 34: 302–311, 1979.
6.
BojarH., MaarK., StaibW.: The endocrine background of human renal cell carcinoma.II. Attempt to induce the R5020 binding components by oestrogens. Urol. Int., 34: 213–319, 1979.
7.
BracciU., Di SilverioF.: Aattuali orientamenti nella diagnosi e terapia dei carcinomi del rene.L'ormonodipendenza. Atti XLIX Congresso Soc. It. Urol., vol. 1-I, pp. 167–195, Ferrara 1976.
8.
ConcolinoG., Di SilverioF., MarocchiA., BracciU.: Renal cancer steroid receptors: Biochemical basis for endocrine therapy.Eur. Urol., 5: 319–322, 1979.
9.
ConcolinoG., MarocchiA., ToscanoV., Di SilverioF.: Nuclear androgen receptor as marker of resposiveness to medroxyprogesterone acetate in human renal cell carcinoma.J. Steroid Biochem., 15: 397–402, 1981.
10.
Di FronzoG., RonchiE., BertuzziA., VezzoniP., PizzocaroG.: Estrogen receptors in renal carcinoma.Eur. Urol., 6: 307–311, 1980.
11.
EORTC Breast Cancer Cooperative Group:Standards for the assessment of oestrogen receptors in human breast cancer.Eur. J. Cancer, 9: 379–381, 1973.
12.
FeunL.G., DrelichmanA., SinghakowintaA., VaitkevicinsV.K., OishiN.: Phase II study of nafoxidine in the therapy for advanced renal carcinoma.Cancer Treat. Rep., 63: 149–150, 1979.
13.
HemstreetP., WittliffeJ.L., SariffA.M., HallM.L., McRaeL.J., DurantJ.R.: Comparison of steroid receptor levels in renal cell carcinoma and autologous normal kidney.Int. J. Cancer, 26: 769–775, 1980.
14.
HrusheskyW.J., MurphyL.P.: Current status of therapy of advanced renal carcinoma.J. Surg. Oncol., 9: 277–288, 1977.
15.
LiS.A., LiJ.J.: Estrogen-induced progesterone receptor in the Syrian hamster kidney.I. Modulation by antiestrogens and androgens. Endocrinology, 103: 2119–2128, 1978.
16.
MaillotK.V., LesmanekP., GentschH.H.: Steroid receptors in tumors of tissues generally considered to be hormone independent.Studies of 120 tumors from female and male patients. J. Cancer Res. Clin. Oncol., 93: 77–84, 1979.
17.
McGuireW.L., HorwitzK.B., PearsonO.H., SegaloffA.: Current status of estrogen and progesterone receptors in breast cancer.Cancer, 39: 2934–2947, 1977.
18.
MoralesA., KirulutaG., LottS.: Hormones in the treatment of metastatic renal cell cancer.J. Urol., 114: 692–693, 1975.
NakamoE., MatsudaM., OsafuneM., SonodaT., SatoB., KotakeT.: Fundamental study of endocrine therapy for renal cell carcinoma: Estrogen receptor in normal kidneys and renal cell carcinoma.Nipp. Hinyokika Gakkai Zasshi, 71: 580–588, 1980.
21.
NakamoE., MatsudaM., OsafuneM., SonodaT., SatoB., KotakeT.: Fundamental study of endocrine therapy for renal carcinoma: Progesterone and androgen receptors in normal kidney and renal cell carcinoma.Nipp. Hinyokika Gakkai Zasshi, 71: 775–787, 1980.
22.
PannutiF., MartoniA., CriccaA.: Pilot study of the treatment of renal clear cell carcinoma by high dose medroxyprogesterone acetate.ICRS Med. Sci. Cancer., 6: 177, 1978.
23.
PizzocaroG., ValenteM., CataldoI., VezzoniP., Di FranzoG.: Estrogen receptors and MPA treatment in metastatic renal carcinoma.A preliminary report. Tumori, 66: 739–742, 1980.
24.
SariffA.M., HemstreetG.P., WittliffJ.L., HallM.L., McRaeJ., DurantJ.R.: Steroid receptor studies in renal cell carcinoma and autologous normal kidney.Fed. Proc., 3: 984, 1980.
25.
ScatchardG.: The attractions of proteins for small molecules and ions.Ann. N.Y. Acad. Sci., 51: 660–672, 1949.
26.
StolbachL.L., BeggC.B., HallT., HortonJ.: Treatment of renal carcinoma: A phase III randomized trial of oral medroxyprogesterone (provera), hydroxiurea, and nafoxidine.Cancer Treat. Rep., 65: 689–692, 1981.
27.
WeiselbergL., BudmanD., VinciguerraV., SchulmanP., DeganT.J.: Tamoxifen in unresectable hypernephroma.A phase II trial and review of the literature. Cancer Clin. Trials, 4: 195–198, 1981.
