HORMONE THERAPY IN METASTATIC BREAST CANCER: CLINICAL RESPONSE AND URINARY GONADOTROPHINS

ABSTRACT The total urinary gonadotrophin output of a group of post menopausal women with metastatic breast carcinoma undergoing hormone therapy, which in every case initially consisted of treatment with diethylstilboestrol, DES (ca. 20 mg/d), has been studied for periods varying from seven months to 3½ years. No correlation between gonadotrophin output and clinical response was found, except that in all cases showing objective regression urinary gonadotrophin remained low throughout the remission period. A low level of gonadotrophin output was not, however, necessarily indicative of a good clinical remission. Following withdrawal of DES, and independent of the period of therapy, recovery to pre-treatment levels was the rule rather than the exception. A small group of patients maintained on a lower dose of DES (3–5 mg/d) showed the same degree of suppression of urinary output as those receiving 20 mg/d, and several of these exhibited objective remissions. The study has emphasised the importance of site specificity in the response to hormone therapy, and underlines the difficulties of relating the clinical response of the patient as a whole to changes in hormonal environment.