Antiandrogen therapy in metastatic male breast cancer: results from an updated analysis in an expanded case series

Luigi Di Lauro, Patrizia Vici, Maddalena Barba, Laura Pizzuti, Domenico Sergi, Massimo Rinaldi, Anna Di Benedetto, Isabella Sperduti, Abeer M. Shaaban, Valerie Speirs, Marcella Mottolese, Ruggero De Maria, Marcello Maugeri-Saccà

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Male breast cancer is a rare disease treated as hormone receptor-positive female breast cancer. The characterization of breast cancer at the molecular level has lately revealed gender-related differences. As the androgen receptor is emerging as a potential oncogenic driver in male breast cancer, we analyzed efficacy data from metastatic patients treated with antiandrogens. We evaluated the activity of cyproterone acetate, either as a monotherapy or combined with a GnRH analog, in 36 metastatic male breast cancer patients. Fourteen patients were treated with cyproterone acetate as monotherapy and 22 patients with complete androgen blockade. We recorded 4 complete responses and 15 partial responses, for an overall response rate of 52.8 % (95 % CI, 36.5-69.4). Stable disease was reported in 11 patients. Median PFS was 8.9 months (95 % CI, 6.1-11.7), and median OS was 24.3 months (95 % CI, 22.5-26.1). Data on androgen receptor expression were available for 7 patients. All the 4 patients with androgen receptor-expressing tumors had a clinical benefit, including a patient with an estrogen receptor-negative disease. Conversely, none of the 3 patients with androgen receptor-negative tumors had a tumor response. Antiandrogen-based therapy showed efficacy in metastatic male breast cancer patients. Our results encourage considering antiandrogens in the therapeutic continuum, especially if supported by androgen receptor expression.

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalBreast Cancer Research and Treatment
Volume148
Issue number1
Early online date20 Sep 2014
DOIs
Publication statusPublished - Nov 2014

Fingerprint

Male Breast Neoplasms
Androgen Antagonists
Androgen Receptors
Cyproterone Acetate
Therapeutics
Breast Neoplasms
Neoplasms
Rare Diseases
Gonadotropin-Releasing Hormone
Estrogen Receptors
Androgens
Hormones

Keywords

  • Metastatic male breast cancer
  • Antiandrogens
  • Cyproterone acetate
  • GnRH analogs
  • Androgen receptor

Cite this

Antiandrogen therapy in metastatic male breast cancer : results from an updated analysis in an expanded case series. / Di Lauro, Luigi; Vici, Patrizia; Barba, Maddalena; Pizzuti, Laura; Sergi, Domenico; Rinaldi, Massimo; Di Benedetto, Anna; Sperduti, Isabella; Shaaban, Abeer M.; Speirs, Valerie; Mottolese, Marcella; De Maria, Ruggero; Maugeri-Saccà, Marcello.

In: Breast Cancer Research and Treatment, Vol. 148, No. 1, 11.2014, p. 73-80.

Research output: Contribution to journalArticle

Di Lauro, L, Vici, P, Barba, M, Pizzuti, L, Sergi, D, Rinaldi, M, Di Benedetto, A, Sperduti, I, Shaaban, AM, Speirs, V, Mottolese, M, De Maria, R & Maugeri-Saccà, M 2014, 'Antiandrogen therapy in metastatic male breast cancer: results from an updated analysis in an expanded case series', Breast Cancer Research and Treatment, vol. 148, no. 1, pp. 73-80. https://doi.org/10.1007/s10549-014-3138-9
Di Lauro, Luigi ; Vici, Patrizia ; Barba, Maddalena ; Pizzuti, Laura ; Sergi, Domenico ; Rinaldi, Massimo ; Di Benedetto, Anna ; Sperduti, Isabella ; Shaaban, Abeer M. ; Speirs, Valerie ; Mottolese, Marcella ; De Maria, Ruggero ; Maugeri-Saccà, Marcello. / Antiandrogen therapy in metastatic male breast cancer : results from an updated analysis in an expanded case series. In: Breast Cancer Research and Treatment. 2014 ; Vol. 148, No. 1. pp. 73-80.
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AU - Sergi, Domenico

AU - Rinaldi, Massimo

AU - Di Benedetto, Anna

AU - Sperduti, Isabella

AU - Shaaban, Abeer M.

AU - Speirs, Valerie

AU - Mottolese, Marcella

AU - De Maria, Ruggero

AU - Maugeri-Saccà, Marcello

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N2 - Male breast cancer is a rare disease treated as hormone receptor-positive female breast cancer. The characterization of breast cancer at the molecular level has lately revealed gender-related differences. As the androgen receptor is emerging as a potential oncogenic driver in male breast cancer, we analyzed efficacy data from metastatic patients treated with antiandrogens. We evaluated the activity of cyproterone acetate, either as a monotherapy or combined with a GnRH analog, in 36 metastatic male breast cancer patients. Fourteen patients were treated with cyproterone acetate as monotherapy and 22 patients with complete androgen blockade. We recorded 4 complete responses and 15 partial responses, for an overall response rate of 52.8 % (95 % CI, 36.5-69.4). Stable disease was reported in 11 patients. Median PFS was 8.9 months (95 % CI, 6.1-11.7), and median OS was 24.3 months (95 % CI, 22.5-26.1). Data on androgen receptor expression were available for 7 patients. All the 4 patients with androgen receptor-expressing tumors had a clinical benefit, including a patient with an estrogen receptor-negative disease. Conversely, none of the 3 patients with androgen receptor-negative tumors had a tumor response. Antiandrogen-based therapy showed efficacy in metastatic male breast cancer patients. Our results encourage considering antiandrogens in the therapeutic continuum, especially if supported by androgen receptor expression.

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