goserelin and Lung-Neoplasms

Topics: Antineoplastic Agents, Hormonal; Bronchodilator Agents; Chylothorax; Gonadotropin-Releasing Hormone; Goserelin; Humans; Leuprolide; Lung Neoplasms; Lung Transplantation; Lymphangioleiomyomatosis; Ovariectomy; Pneumothorax; Progesterone; Respiratory Insufficiency

A 66-year-old, man was referred to our hospital for further examination of multiple pulmonary nodules on chest X-ray performed on medical examination. He was referred to our clinic because his chief complaint was poor urinary stream. Prostatic cancer was suspected on digital rectal examination and magnetic resonance imaging. Serum prostatic specific antigen (PSA) level was 134.9 ng/ml. Histological examination of transrectal prostatic sextant biopsy revealed well differentiated adenocarcinoma of prostate. Abdominal computed tomography-scan, gastro-intestinal tract examination and bone scintigraphy demonstrated no other primary lesions or distant metastases. Under the diagnosis of prostatic cancer with multiple pulmonary metastasis, we performed total androgen blockade (TAB) consisting of luteinizing hormone releasing hormone agonist and flutamide following dietylstilbestrol (DES) intravenous injection therapy. After three months, pulmonary nodules disappeared on chest X-ray and PSA level decreased to below 0.1 ng/ml. Pulmonary nodules also disappeared on CT-scan after six months after TAB. He is alive and free from the recurrence for 42 months.

Topics: Adenocarcinoma; Aged; Androgen Antagonists; Antineoplastic Agents, Hormonal; Diethylstilbestrol; Drug Administration Schedule; Flutamide; Gonadotropin-Releasing Hormone; Goserelin; Humans; Lung Neoplasms; Male; Prostate-Specific Antigen; Prostatic Neoplasms; Tomography, X-Ray Computed

Prostatic cancer is rarely diagnosed by detection of lung metastases. We report a case of prostatic cancer in a 73-year-old man detected by abnormalities in chest X-ray and serum prostate specific antigen (PSA) level. He was initially admitted to our hospital due to elevation of PSA level. On the first transperineal prostatic needle biopsy, prostatic cancer was not detected and he was followed. Seven months after the first biopsy, chest X-ray revealed multiple abnormal nodules in the lung fields bilaterally and PSA level was again elevated. A second prostatic biopsy and whole-body examination were performed, and he was diagnosed with moderately differentiated prostatic adenocarcinoma with multiple lung metastases. Complete androgen blockade therapy was performed immediately. Two months after the beginning of treatment, PSA level was normalized and the multiple lung metastases had completely disappeared. There has been no evidence of recurrence or PSA relapse 24 months after detection of the prostatic cancer. This is the 26th case of prostatic cancer diagnosed in Japan following detection of multiple lung metastases.

Topics: Adenocarcinoma; Aged; Androgen Antagonists; Antineoplastic Agents, Hormonal; Biomarkers, Tumor; Drug Therapy, Combination; Flutamide; Goserelin; Humans; Lung Neoplasms; Male; Prostate-Specific Antigen; Prostatic Neoplasms; Radiography; Treatment Outcome

This pilot study aimed to test the possibility of therapeutic benefit imparted by early intervention based on sequential tumour marker (TM) measurements during follow-up of primary breast cancer (PBC) patients.. Patients with oestrogen receptor positive PBC with no clinical and/or radiological evidence of metastases were recruited and followed-up 3-monthly with clinical assessment and TM (CA15.3 and CEA) measurements. The clinical team was blinded to the TM results. Asymptomatic patients who developed raised TMs (based on pre-defined cut-offs) were randomised to either 'treatment change' (either start or change of adjuvant endocrine agent to another agent) or 'no change' (control). Patients who developed symptomatic metastases came off the study. The primary and secondary endpoints were intervals from randomisation to symptomatic metastases and to last follow-up/death respectively.. Eighty-five patients (median age = 54 years (30-72)) were recruited with a median follow-up of 81 months (1-124). Sixteen patients were randomised as described. There was no significant difference (treatment change versus no change) with regards to interval from randomisation to symptomatic metastases - 23 (2-62) and 22 (1-63) months respectively (p = 0.9), as well as interval from randomisation to last follow-up/death - 36 (7-63) and 37 (10-63) months respectively (p = 0.9).. Despite long follow-up (up to 10+ years), this small study has thus far shown no significant difference in outcome. However, we have confirmed the feasibility of this study design but a larger study will be required to show if there is a benefit to this approach.

Topics: Adult; Aged; Anastrozole; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Breast Neoplasms; Carcinoembryonic Antigen; Early Detection of Cancer; Female; Follow-Up Studies; Goserelin; Humans; Liver Neoplasms; Lung Neoplasms; Middle Aged; Mucin-1; Nitriles; Pilot Projects; Single-Blind Method; Tamoxifen; Treatment Outcome; Triazoles

The EORTC conducted two randomized phase III trials of maximal androgen blockade (MAB) in 695 patients with metastatic prostate cancer. Trial 30,843 compared orchidectomy or buserelin to buserelin plus cyproterone acetate and showed no significant difference in survival while trial 30,853 showed that Zoladex plus flutamide had a significantly longer survival than orchidectomy. Reasons for this discrepancy were sought.. In order to determine whether differences in patient characteristics could explain these possibly contradictory results, a Cox proportional hazards regression model was used to identify prognostic factors for survival in each study. Patients were divided into risk groups (good or poor prognosis with 3.5 and 1.75 years' median survival, respectively) based on their alkaline phosphatase, hemoglobin, performance status, pain score, T category and G grade at entry on study.. The survival advantage of MAB in 30,853 was limited to patients with a good prognosis (164/302 (54%) of the patients). In 30,843, only 93/337 patients (28%) had a good prognosis so there were insufficient data to draw separate conclusions in these patients. Despite the limitations of subgroup analyses, these results show that patients in 30,843 had on the average a worse prognosis than patients in 30,853. Hence there were fewer good prognosis patients who could potentially benefit from MAB, thus providing one possible explanation for the overall negative conclusion.. These studies once again underline the importance of taking into account patient characteristics when designing and interpreting metastatic prostate cancer trials. They also provide criteria which may be used to define risk groups as part of a protocol's patient eligibility criteria. In the design of future trials assessing MAB, a sufficient number of good prognosis patients should be entered to reliably assess treatment efficacy in this subgroup.

Topics: Aged; Analysis of Variance; Androgen Antagonists; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Buserelin; Combined Modality Therapy; Cyproterone Acetate; Disease-Free Survival; Flutamide; Goserelin; Humans; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Orchiectomy; Prognosis; Proportional Hazards Models; Prostatic Neoplasms; Risk Assessment; Survival Rate

A woman in her early 20s presented with cough and fever. She had undergone an abdominal myomectomy 3 years ago for uterine leiomyoma. Chest CT and positron emission tomography-CT revealed multiple round nodules in both lungs, suggesting metastatic lesions. A CT-guided lung biopsy was performed, and the tumour was diagnosed as pulmonary benign metastasising leiomyoma (PBML) based on pathological analyses. Whole exon capture sequencing of uterine leiomyoma and PBML sections revealed that 13 genes (MCM10, SLC16A9, RAG1, BAZ1A, NLRP2, TRMT61B, CPXM1, NGLY1, SUCLG2, FAM13A, CAGE1, PHTF2 and ZDHHC2) were concurrently present in the two tumours. The patient was prescribed goserelin injections every 4 weeks. The symptoms improved 2 weeks after starting the treatment. The lung nodules considerably decreased in size after three courses of goserelin treatment. The nodular size continues to decrease with the treatment.

Topics: Chromosomal Proteins, Non-Histone; Exons; Female; Goserelin; GTPase-Activating Proteins; Humans; Leiomyoma; Lung; Lung Neoplasms; Mutation; Uterine Neoplasms

Goserelin plus aromatase inhibitors (AI) have already been used in male advanced breast cancer, but the cases that fulvestrantin male breast cancer are rare.. Here we report a case of long-term (3 years) response to Goserelin plus continuing endocrine treatments given for a male advanced breast cancer. The patient prolongs his life with high life quality, and has more time with his family.. Goserelin plus endocrine treatments may benefit male breast cancer.

Topics: Adult; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms, Male; Contraceptives, Oral, Synthetic; Goserelin; Humans; Lung Neoplasms; Male; Medroxyprogesterone; Prognosis

Benign metastasising leiomyoma (BML) is a rare entity characterised by uterine leiomyoma that, later on, develops slow-growing metastasis mainly to the lung. In general, these lung metastases are incidentally discovered, but sometimes can become symptomatic with dyspnoea, cough and chest pain. The expression of oestrogen and progesterone receptors by these tumours supports the idea that they respond to hormone therapy (chemical, with oestrogen receptor modulators, aromatase inhibitors or luteinising hormone releasing hormone analogues and surgical, with bilateral adnexectomy). The authors present a case report of BML with two peculiarities: a less common pattern of metastisation (soft tissue), in addition to lung; and disease progression despite treatment with chemical and surgical castration.

Topics: Antineoplastic Agents, Hormonal; Back; Biopsy; Diagnosis, Differential; Disease Progression; Female; Forearm; Goserelin; Humans; Leiomyoma; Lung Neoplasms; Middle Aged; Radiography, Thoracic; Soft Tissue Neoplasms; Thorax; Tomography, X-Ray Computed; Uterine Neoplasms

Approximately 50% of patients with low-grade endometrial stromal sarcoma (ESS) develop recurrent disease including mainly metastases of pelvis and lung. A solitary pulmonary metastasis of this disease is a rare phenomenon.. After initial surgical treatment in 1990, a 28-year-old female developed solitary metastases of the lung in 1998 and 1999, which were surgically removed both times. The patient was then treated with goserelin for 2 years followed by anastrozole to date. She has since been disease-free.. This case report emphasizes the importance of long-term follow-up and initial surgical treatment of low-grade ESS and suggests systemic hormonal therapy in case of recurrence.

Topics: Adult; Anastrozole; Antineoplastic Agents, Hormonal; Combined Modality Therapy; Disease-Free Survival; Endometrial Neoplasms; Female; Goserelin; Humans; Lung Neoplasms; Neoplasm Recurrence, Local; Nitriles; Sarcoma, Endometrial Stromal; Triazoles

Topics: Androgens; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Aromatase Inhibitors; Breast Neoplasms, Male; Goserelin; Humans; Letrozole; Lung Neoplasms; Male; Middle Aged; Nitriles; Triazoles

We report two patients with lung metastasis of breast cancer who had durable complete responses (CR) with goserelin. The first patient was a 48-year-old woman diagnosed with left breast cancer (T1N0M0, Stage I) at the age of 40, for which she underwent mastectomy. The tumor was estrogen receptor (ER) and progesterone receptor (PgR) positive. She received tamoxifen for 2 years as adjuvant therapy. After 8 years and 7 months, a lung metastasis was found by chest X-p, and treatment with goserelin was started. After 11 months of this treatment a CR was achieved, and the response lasted 3 years and 5 months. The second patient was a 38-year-old woman with a diagnosis of lung metastasis. She underwent right mastectomy at the age of 29 for breast cancer (T2N1M0, Stage IIB), and the tumor was ER and PgR positive. She received tamoxifen and doxifluridine for 2 years as adjuvant therapy. Eight years and 6 months after the mastectomy, a lung metastasis was found by chest X-p, and goserelin treatment was started. After 8 months of this treatment, chest X-p and CT revealed a complete regression of the lung metastasis, and response lasted 1 years and 7 months. Serum estradiol levels were suppressed below 10 pg/ml during the treatment in both patients. These results indicate the usefulness of LH-RH agonist in the treatment of recurrent breast cancer.

Topics: Adult; Antineoplastic Agents, Hormonal; Breast Neoplasms; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Lung Neoplasms; Middle Aged; Radiography, Thoracic; Receptors, Estrogen; Receptors, Progesterone

In hemodialysis patients, few cases of prostate cancer have been reported until recently. We present a case of prostate cancer with multiple lung metastases in a chronic hemodialysis patient. A 65-year-old Japanese man who had maintained hemodialysis for 5 years was referred to our hospital with multiple metastatic lung tumors. Serum prostate tumor markers were highly elevated although his plasma testosterone level was within the normal range. A transrectal needle prostate biopsy confirmed a histologic diagnosis of moderately differentiated adenocarcinoma. Androgen blockade therapy was very effective as evidenced by a quick decrease of serum tumor markers. The follow-up computed tomography scan of the chest performed 3 months later showed a complete disappearance of the coin lesions. The early detection of prostate cancer in hemodialysis patients is difficult because of a lack of urologic symptoms, which indicate the importance of periodic screening by serum tumor markers. Combined androgen blockade is effective even in hemodialysis patients. However, close follow up is necessary because long-term results and prognoses are still unknown.

Topics: Adenocarcinoma; Aged; Androgen Antagonists; Antineoplastic Agents, Hormonal; Drug Therapy, Combination; Flutamide; Goserelin; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Radiography, Thoracic; Renal Dialysis; Tomography, X-Ray Computed

The patient was a 38-year-old woman who was diagnosed as having right breast cancer (T1aN1bM0, stage II) at the age of 36 when she underwent right mastectomy. Postoperative adjuvant therapy was performed using UFT and tamoxifen. After 2 years and 4 months, pulmonary metastasis was diagnosed from elevated tumor markers and chest X-P. After the relapse, treatment with goserelin acetate (Zoladex) and CPA was started. After 2 months of this treatment, the tumor in the lung had shrunk in size, and after 5 months partial remission (PR) was evaluated from improvements in chest X-P and normalization of tumor markers, This PR condition continues at present. A case report is presented of a patient with premenopausal recurrent breast cancer in whom good results were obtained by concomitant administration of Zoladex and CPA.

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cyclophosphamide; Female; Goserelin; Humans; Lung Neoplasms; Mastectomy; Premenopause; Remission Induction

Benign metastasising leiomyoma is a rare disease occurring predominantly in women of childbearing age and is hormonally influenced. The response of the disease to the luteinising hormone releasing hormone analogue goserelin is reported.

Topics: Adult; Antineoplastic Agents, Hormonal; Female; Goserelin; Humans; Leiomyomatosis; Lung Neoplasms

A 65-year-old man with advanced prostate cancer was treated with a luteinizing hormone-releasing hormone (LH-RH) analogue. Four days after the initial injection of 3.6 mg of goserelin acetate, severe dyspnea developed due to worsening pleuritis carcinomatosa, which was considered as a flare-up. Chest drainage was required to save his life. Therefore, we emphasize the importance of treatment to prevent tumor flare during LH-RH analogue therapy.

Topics: Adenocarcinoma; Aged; Drainage; Goserelin; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Pleural Effusion, Malignant; Prostatic Neoplasms

Pulmonary lymphangioleiomyomatosis is a chronic devastating disorder afflicting women of childbearing age, characterized by proliferation of atypical smooth muscle in the lung. Attempts to treat this disease have shown that a number of hormonal manipulations may be helpful but that surgical oophorectomy alone or associated with administration of progesterone is the most effective treatment. This report describes the response to treatment with an analog of luteinizing-hormone-releasing hormone, goserelin, which is able to induce a marked suppression of the secretion of ovarian sex steroid and demonstrates with pulmonary function studies, arterial blood gas determinations, and bronchoalveolar lavage parameters that this patient's disease was responsive to this agent.

Topics: Adult; Buserelin; Estradiol; Female; Gonadotropin-Releasing Hormone; Gonadotropins, Pituitary; Goserelin; Humans; Lung; Lung Neoplasms; Lymphangiomyoma; Progesterone; Radiography; Testosterone

Lymphangitic carcinomatosis of the lung is a late and often fatal manifestation of cancer. We describe a case of a biopsy-proved pulmonary lymphangitic carcinomatosis in an asymptomatic 61-year-old man. The pulmonary picture proved to be the initial sign of a prostatic cancer. Therapy with LH-RH analogues and antiandrogens achieved a complete clearance of lung involvement.

Topics: Buserelin; Carcinoma; Flutamide; Goserelin; Humans; Lung Neoplasms; Lymphangitis; Male; Middle Aged; Prostatic Neoplasms

A series of tumour related markers have been examined in 179 patients receiving primary endocrine therapy for metastatic breast cancer. Significant correlations between therapeutic response (UICC criteria after 6 months of treatment) and appropriate alterations in serum concentrations of carcinoembryonic antigen, ferritin, c-reactive protein, orosomucoid and the erythrocyte sedimentation rate, have been observed when changes in these markers were examined only at high serum concentrations. By combining these five markers a 'therapeutic index' of response has been devised which can be employed at an early stage of treatment in more than 90% of patients, giving an overall sensitivity/specificity of 90%/78% for therapeutic response or disease stabilisation over a 6-month period. The design of an objective measurement of response, which is easy to perform, has the potential to replace the existing, largely subjective. UICC criteria for retrospective judgement of response, and may also be used to direct systemic endocrine therapy.

Topics: Biomarkers, Tumor; Blood Sedimentation; Bone Neoplasms; Breast Neoplasms; Buserelin; C-Reactive Protein; Carcinoembryonic Antigen; Female; Ferritins; Goserelin; Humans; Lung Neoplasms; Megestrol; Megestrol Acetate; Orosomucoid; Ovariectomy; Tamoxifen

Ferritin concentrations have been measured in serum from 266 patients receiving primary endocrine therapy for advanced breast cancer. Concentrations were significantly higher at presentation of advanced disease than in 55 tumour-free control patients. A positive correlation existed between increasing serum ferritin and tumour burden at presentation. A strong correlation was also found between therapeutic response and changes in serum ferritin (above 200 micrograms/l) in patients with distant metastases. More than one third of patients presenting with Stage IV disease developed concentrations in excess of 200 micrograms/l during initial treatment.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Biomarkers, Tumor; Bone Neoplasms; Breast Neoplasms; Buserelin; Female; Ferritins; Follow-Up Studies; Goserelin; Humans; Lung Neoplasms; Megestrol; Megestrol Acetate; Middle Aged; Neoplasm Staging; Ovariectomy; Remission Induction; Retrospective Studies; Tamoxifen

Ovarian granulosa cell tumor lung metastases regressed, and symptoms were relieved, during gonadotropin-releasing hormone (GnRH) agonist analog therapy after the failure of operative treatment and cytotoxic chemotherapy, indicating the hormone dependence of the malignancy. The response was transient, but the largest metastasis did not relapse. This case report suggests that GnRH analogs may offer a new approach to the treatment of ovarian stromal cell malignancies.

Topics: Bone Neoplasms; Buserelin; Female; Goserelin; Granulosa Cell Tumor; Humans; Lung Neoplasms; Middle Aged; Ovarian Neoplasms; Pituitary Hormone-Releasing Hormones

Topics: Bone Neoplasms; Breast Neoplasms; Buserelin; Female; Goserelin; Humans; Lung Neoplasms; Middle Aged

Ten previously untreated postmenopausal women with metastatic breast cancer, none of whom had received prior systemic therapy, were treated with the luteinising hormone releasing hormone (LHRH) analogue D-Ser(But)6, Azgly10-LHRH (ICI 118630). Two obtained an objective partial remission, one in bone metastases and one in lung metastases. One patient proved unassessable. Amongst the seven failures, incomplete pituitary gonadotrophin suppression over the relatively short treatment period with the daily injections was noted. The seven patients failing ICI 118630 received tamoxifen and two with high tumour oestrogen receptor values responded. LHRH analogues may provide a novel endocrine therapy for postmenopausal breast cancer although more data are needed. In this study, the monthly depot injection proved superior to daily injections with regard to gonadotrophin suppression, although it is not clear that this provides the mechanism of action.

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Buserelin; Female; Follicle Stimulating Hormone; Goserelin; Humans; Lung Neoplasms; Luteinizing Hormone; Menopause; Middle Aged; Remission Induction