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PIONEER: pre-operative window study of letrozole plus progesterone receptor agonist megestrol acetate versus letrozole alone in post-menopausal patients with oestrogen receptor-positive breast cancer

Abstract:
Pre-clinical studies have identified functional ‘cross- talk’ between the receptors for oestrogen (ER) and progesterone (PR) in breast cancer (Mohammed et al., 2015). Addition of a PR agonist to anti-oestrogen therapy directly modifies ERa chromatin binding and transcription in breast cancer cells, and is anti-proliferative in both in vitro and in vivo models. A semi-synthetic progesterone derivative, Megestrol Acetate (MA) is licensed for use in metastatic ER? breast cancer, and is also used at a lower dose to ameliorate endocrine therapy-related hot flushes. Aims/Objectives: PIONEER is evaluating the anti-proliferative effect of combining MA with anti-oestrogen therapy (letrozole—LET) to determine the value of a follow-on adjuvant study.
Authors:
RA Burrell, SS Kumar, A Kateb, G Dougall, J Wulff, J Benson, P Forouhi, A Agrawal, S McIntosh, P King, Z Raytor, H Sweetland, V Pitsinis, S Hadad, H Hamed, P Schmid, C Caldas, P Pantziarka, E Provenzano, JS Carroll, RD Baird
Publication date:
1st Apr 2020
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