Alterations in the Metabolism of Oestrogens During Treatment with Aminoglutethimide in Breast Cancer PatientsPreliminary Findings
作者:
P.E. Lønning,
S. Kvinnsland,
T. Thorsen,
P.M. Ueland,
期刊:
Clinical Pharmacokinetics
(ADIS Available online 1987)
卷期:
Volume 13,
issue 6
页码: 393-406
ISSN:0312-5963
年代: 1987
出版商: ADIS
数据来源: ADIS
摘要:
In this small study, the effect of aminoglutethimide on the disposition of oestrogens in women with advanced breast cancer was investigated using bolus injections of 4-[14C]-oestradiol and 6,7-[3H]-oestrone sulphate, alone or in combination.No alterations in oestrogen disposition were seen after short term (6 hours) aminoglutethimide administration. During long term (3 weeks to 8 months) aminoglutethimide treatment mean 4-[14C]-oestradiol clearance was not changed.14C-Oestrone sulphate AUC was reduced by 43% at a low dose of aminoglutethimide (125mg twice daily) and by 65% at a high dose (250mg 4 times daily) with hydrocortisone acetate 25mg twice daily. The oestrone sulphate terminal elimination rate constant (&lgr;z) was concurrently increased (mean of 46 and 79%, respectively, with the 2 dosage regimens).A possible increase in oestrone sulphate clearance during long term treatment was tested for by injecting 6,7-[3H]-oestrone sulphate. These studies revealed a marked increase (mean 104%) in oestrone sulphate clearance in patients receiving the high dose aminoglutethimide schedule.Following injection of 4-[14C]-oestradiol plus 6,7-[3H]-oestrone sulphate, the fraction of 4-[14C]-oestradiol metabolised to oestrone sulphate was found to be reduced in all patients (mean 13%). A mean increase of 80% in the urinary excretion of14C-oestriol was observed after 4-[14C]-oestradiol administration.Our results, although preliminary, suggest that aminoglutethimide is a potent inducer of aminoglutethimide metabolism, thereby producing a significant reduction in plasma bioavailability of oestrone sulphate. These effects may have a role in the action of aminoglutethimide, a finding which warrants further investigation.
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