Diverse prognosis in metastatic breast cancer: Who should be offered alternative initial therapies?

Introduction Physicians have been using hormonal manipulation to treat advanced breast cancer for almost a century. Surgical ablation of the ovaries, adrenals, and pituitary glands has achieved remarkable tumor regression in sensitive patients. Alternatively, large doses of estrogens, progestins, and androgens have achieved similar results. More recently, the emergence of new therapies, such as antiestrogens, LHRH agonists, and chemical blockade of adrenal steroid biosynthesis offer additional choices. Within limits, all of these therapies are equally effective in sensitive patients. The trend at the present time is to select a therapy that will produce a good response with minimal toxicity. Here the participating physicians will discuss one such therapy — Megace (megestrol acetate). They will consider the role of Megace in the treatment of advanced breast cancer along with issues such as toxicity, dose response, etc.A series of teleconferences has been organized under the auspices of Bristol-Myers to address several major current questions in oncology. A panel of recognized experts with a moderator has been assembled to discuss each question, and we are reporting a number of these discussions in Breast Cancer Research and Treatment. This is reprinted from Oncology Viewpoints, courtesy of Bristol-Myers Oncology Division, Evansville IN 47721, USA.