Eighty-five postmenopausal women with metastatic breast cancer were randomized to receive aminoglutethimide (AG), medroxyprogesterone acetate (MPA), or AG+MPA. Patients with aggressive visceral disease were excluded. Response was observed in 36% of the patients in the AG treatment group, 31% in the MPA treatment group, and 47% in the combination treatment group. Statistical analysis showed that the percentage of responders was not different among the three treatment groups. Similarly, the duration of response did not differ. Toxicity of all three regimens was moderate, not necessitating discontinuation of treatment. In conclusion, AG, MPA and the combination of AG+MPA were found to be equally effective therapies for metastatic breast cancer in postmenopausal women with nonaggressive visceral disease. The lack of statistically significant superiority of the combination of AG+MPA suggests that sequential endocrine monotherapies may be more beneficial than combined hormonotherapies for this patient population.
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