High-dose
medroxyprogesterone acetate (HD-MPA) has been successfully employed in the treatment of
hormone-related
tumors, especially advanced
breast cancer. However,
progestins in general and MPA in particular are considered a useful treatment also in other types of
tumors such as endometrial, prostatic and
renal cancer. Furthermore, MPA has been evaluated in
tumors which are not classically considered
hormone-related, such as
ovarian cancer.
Therapy with one of a number of
progestational agents has been the conventional approach to the management of
endometrial carcinoma not amenable to surgery or
radiation therapy. Among the various
synthetic progestins, MPA has been the most widely employed both by i.m. and oral routes, according to a variety of doses and schedules. Objective responses have been obtained in a percentage of women varying between 30 and 50% in the different series. While the role of MPA in the
palliative treatment of advanced disease is well accepted, opinion is divided on the role of
progestins in the adjuvant setting. On the basis of available data, it should be concluded that the usefulness of adjuvant
therapy with
progestins in high risk, early-stage
endometrial cancer has not yet been clearly demonstrated. As far as
prostatic cancer is concerned, data coming from comparative trials show that MPA is less effective than
diethylstilbestrol (DES), and therefore should not be considered the first choice for previously untreated patients. However, it can achieve responses in patients who no longer respond or who are refractory to DES, and represents the treatment of choice for those patients who, due to their cardiovascular conditions, cannot be given
estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)