Medical Oncology

, Volume 21, Issue 4, pp 309–318 | Cite as

Tamoxifen and megestrol acetate for postmenopausal breast cancer

Diverging effects on liver proteins, androgens, and glucocorticoids
  • L. Löfgren
  • B. Wallberg
  • N. Wilking
  • T. Fornander
  • L. E. Rutqvist
  • K. Carlström
  • B. von Schoultz
  • E. von Schoultz
Original Article

Abstract

Aim: To compare the effects of tamoxifen and megestrol acetate on liver proteins, androgens, and glucocorticoids during adjuvant treatment for postmenopausal breast cancer.

Methods: A subgroup of women within a large prospective multicenter trial were followed with blood sampling every 3 mo during 2 yr. Women were randomized to receive either continuous tamoxifen 40 mg/d or repeated sequential treatment with tamoxifen and megestrol acetate (MA) 160 mg/d.

Results: We found profound and distinct differences between the two regimens. Tamoxifen increased steroid-binding proteins (SHBG and CBG) and suppressed circulating androgens and IGF-I. In contrast, the metabolic effects of tamoxifen were clearly antagonized by MA. There was a rise in IGF-I and marked suppression of steroid-binding proteins. Levels of free testosterone were reduced by 70%. MA also caused apparent adrenal suppression.

Conclusion: The different effects on anabolic/catabolic balance and adrenal function may relate to certain clinical effects during treatment.

Key Words

Postmenopausal breast cancer adjuvant treatment endocrine effects metabolic effects tamoxifen megestrol acetate 

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Copyright information

© Humana Press Inc 2004

Authors and Affiliations

  • L. Löfgren
    • 1
  • B. Wallberg
    • 2
  • N. Wilking
    • 2
  • T. Fornander
    • 3
  • L. E. Rutqvist
    • 3
  • K. Carlström
    • 4
  • B. von Schoultz
    • 5
  • E. von Schoultz
    • 2
  1. 1.Department of SurgerySt Görans HospitalStockholmSweden
  2. 2.Department of Oncology, RadiumhemmetKarolinska HospitalStockholmSweden
  3. 3.Department of OncologyHuddinge University HospitalStockholmSweden
  4. 4.Department of Obstetrics and GynecologyHuddinge University HospitalStockholmSweden
  5. 5.Department of Obstetrics and GynecologyKarolinska HospitalStockholmSweden

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