Medical adrenalectomy with aminoglutethimide: Clinical studies in postmenopausal patients with metastatic breast carcinoma

S. A. Wells, R. J. Santen, Allan Lipton, D. E. Haagensen, E. J. Ruby, Harold Harvey, W. G. Dilley

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

The use of adrenalectomy and hypophysectomy in the management of postmenopausal patients with metastatic breast carcinoma is reserved for highly selected patients. As an alternate approach, a pharmacologic method of inhibiting adrenal cortical secretion was developed which consisted of the daily administration of 1000 mg of aminoglutethimide to block steroidogenesis and either dexamethasone (2.0-3.0 mg/day) or hydrocortisone (40-60 mg/day) as replacement glucocorticoid. This regimen markedly suppressed plasma levels of DHA-S, androstenedione, estrone, and estradiol, and urinary levels of aldosterone. Of 50 patients treated, 19 (38%) demonstrated either a complete (8/19) or a partial (11/19) objective disease remission which lasted for 18.05 ± 3.1 months (mean ± SEM). In 10 (20%) patients, there was stabilization of disease (7.8 ± 1.2 months), accompanied by symptomatic relief of bone pain in six (12%). There was disease progression in 20 (40%) patients. The acute side effects of aminoglutethimide therapy were significant and consisted of transient lethargy (41.5%) and a cutaneous rash (35.8%). Chronic toxicity was negligible. The medical adrenalectomy regimen of aminoglutethimide plus glucocorticoid offers a suitable alternative to surgical adrenalectomy or hypophysectomy in the management of postmenopausal patients with metastatic breast carcinoma.

Original languageEnglish (US)
Pages (from-to)475-484
Number of pages10
JournalUnknown Journal
Volume187
Issue number5
DOIs
StatePublished - Jan 1 1978

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Aminoglutethimide
Adrenalectomy
Breast Neoplasms
Hypophysectomy
Glucocorticoids
Lethargy
Androstenedione
Estrone
Exanthema
Aldosterone
Dexamethasone
Disease Progression
Hydrocortisone
Clinical Studies
Estradiol
Bone and Bones
Pain

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Wells, S. A. ; Santen, R. J. ; Lipton, Allan ; Haagensen, D. E. ; Ruby, E. J. ; Harvey, Harold ; Dilley, W. G. / Medical adrenalectomy with aminoglutethimide : Clinical studies in postmenopausal patients with metastatic breast carcinoma. In: Unknown Journal. 1978 ; Vol. 187, No. 5. pp. 475-484.
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Medical adrenalectomy with aminoglutethimide : Clinical studies in postmenopausal patients with metastatic breast carcinoma. / Wells, S. A.; Santen, R. J.; Lipton, Allan; Haagensen, D. E.; Ruby, E. J.; Harvey, Harold; Dilley, W. G.

In: Unknown Journal, Vol. 187, No. 5, 01.01.1978, p. 475-484.

Research output: Contribution to journalArticle

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