THE EFFECT OF ENDOCRINE THERAPY WITH MEDROXYPROGESTERONE ACETATE, 4-HYDROXYANDROSTENEDIONE OR TAMOXIFEN ON PLASMA-CONCENTRATIONS OF INSULIN-LIKE GROWTH-FACTOR (IGF)-I, IGF-II AND IGFBP-1 IN WOMEN WITH ADVANCED BREAST-CANCER

Tamoxifen treatment of women with advanced breast cancer has previously been reported to reduce plasma insulin-like growth factor-type I (IGF-I) concentrations. In this study we have examined the effect of treatment with Tamoxifen, medroxyprogesterone acetate (MPA) or 4-hydroxyandrostenedione (4-OHA) on plasma IGF-I and IGF-II concentrations. As IGF-binding proteins (IGFBPs) can modulate the biological effects of IGF-I, plasma IGFBP-I levels were also measured. Treatment with Tamoxifen for 2 weeks resulted in a small, but significant, decrease in IGF-I levels, but increase in the plasma concentration of IGFBP-I. In contrast, treatment with MPA increased levels of IGF-I, but significantly reduced plasma IGFBP- I concentrations. Treatment with 4-OHA had no significant overall effect on plasma IGF-I or IGFBP- I levels, although changes were detected for some subjects. Plasma IGF-II concentrations were not altered by treatment with Tamoxifen, MPA or 4-OHA. It is concluded that although treatment with Tamoxifen or MPA produced significant changes in plasma IGF-I concentrations, any physiological effects of such changes are likely to be modulated by the corresponding alterations in plasma IGFBP- I concentrations.