Response to aminoglutethimide and cortisone acetate in advanced prostatic cancer

Abstract

Summary Forty patients with metastatic adenocarcinoma of the prostate were evaluated for response to treatment with aminoglutethimide plus cortisone acetate. All had relapsed from or failed to respond to primary endocrine treatment with orchidectomy or stilboestrol. Nineteen patients (48%) showed subjective response, in most cases relief of bone pain. Side effects limited treatment in only 3 patients. We conclude that aminoglutethimide plus cortisone acetate is a useful addition to the treatment available for this difficult group of patients. The mechanism by which this treatment has a beneficial effect remains unclear.

Benefits of Combination Therapy with Flutamide in Patients Relapsing after Castration

“…Bilateral adrenalectomy has been associated with palliation in 20 to 70% of patients with advanced prostatic carcinoma who had become refractory to castration or oestrogen therapy (Harrison et al, 1953;Moraleset al, 1955;MacFarlane etal., 1960;Bhanalaph et al, 1974;Fergusson, 1975). A similar response was observed with medical adrenalectomy using aminoglutethimide (Robinson et al, 1974;Worgul et al, 1983;Drago et al, 1984;Ponder et al, 1984;Murray and Pitt, 1985).…”

Aromatase Inhibitors in Malignant Diseases of Aging

“…However, aminoglutethimide is usually given with hydrocortisone, and the latter suppresses plasma androgens (MacAdams et al 1986). The possibility exists that any response to this combined treatment with aminoglutethimide plus hydrocortisone could be due to hydrocortisone alone (Dowsett et al 1988;Plowman et al 1987;Ponder et al 1984). …”

Current Concepts in the Treatment of Prostate Cancer

“…lH.W The primary clinical goal for these patients IS relief of symptoms rather than objective evidence of shrinkage of the tumor mass. 40 The treatment of choice in patients who have relapsed following a remission to, or failed to benefit from, orchiectomy or estrogen treatment is uncertain. Alternate drug therapy may involve the use of other estrogens, antiandrogens, progestogens, and medical adrenalectomy in the desire to suppress or abolish androgen stimulation of the prostatic cells.""…”