Abstract
e11502 Background: Blocking estrogen receptor or production is standard of care for hormone receptor positive advanced breast cancer patients. A paradoxical approach of using estrogens in such patients has been used for the last 5-6 decades. The mechanism of action of diethylstilbestrol (DES) focuses on induction of apoptosis. Methods: Fifteen cases of hormone receptor positive advanced breast cancer were treated with DES after failure of standard hormonal chemotherapy. Median age was 55 years. Median time before starting DES for metastatic disease was 2.5 years. Median lines of chemotherapy received before starting DES was two. All patients had received aromatase inhibitors, tamoxifen. Ten patients had also received fulvestrant. Nine patients had liver, nine had bone, six had lymph node, four had lung, and two had skin metastasis. Results: 5 mg BID dose of DES was started. After a period of median 6 month therapy, there were four partial responses, six patients had stable disease, and five had progressive disease. Reduction in serum markers CA15.3 and CEA was seen in eight patients. The therapy was well tolerated. There was mild elevation of liver enzymes – SGOT and SGPT in four cases. There were no other untoward toxicity. Conclusions: In post menopausal hormone receptor positive cases of advanced breast cancer, after failure of standard hormone therapy, DES offers safe, cheap, and effective palliative treatment. No significant financial relationships to disclose.
Published Version
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