Antitumor effect of two oral steroids, mepitiostane and fluoxymesterone, on a pregnancy-dependent mouse mammary tumor (TPDMT-4)

Pregnancy-dependent TPDMT-4 mammary tumors, characterized by requiring estrogen, progesterone, and pituitary hormones for growth, grew continuously in female DDD mice carrying pituitary isografts. The experimental model was used to investigate the antitumor effects of two p.o. steroids, mepitiostane and fluoxymesterone. When tumors implanted with pituitary isografts into the fat-pad reached palpable size, animals received 6 doses/week of 0.1, 0.3, 1.0, and 3.0 mg of either steroid intragastrically. Mepitiostane significantly suppressed tumor growth with regression in 25 and 29 percent of animals at 1.0 and 3.0 mg, respectively, but had no inhibitory effects at other doses. Fluoxymesterone retarted tumor growth during the first week of treatment at 3.0 mg but finally had no inhibitory effects at any doses. Under similar conditions ovariectomy caused tumor regression immediately, and epitiostanol, the parent steroid of mepitiostane, significantly suppressed tumor growth when given in 3 injections/week of 0.5 mg s.c. Tumous had papillary structures and almost lacked secretory activity. A comparison of these findings to those obtained with earlier generations suggests that TPDMT-4 tumors became less sensitive to the antitumor effect of epitiostanol and were able to grow at lower hormone levels with succeeding generations. Morphologically, progression to more cancer and less secretory activity was noticed.

Effects of synthetic androgen fluoxymesterone on triglyceride secretion rates in the rat

Fluoxymesterone, a C-17 methylated derivative of testosterone employed in the treatment of renal-failure patients with refractory anemia, was administered to Sprague-Dawley rats and the effects on plasma triglyceride (TG) and immunoreactive insulin (IRI) levels and the rate of hepatic triglyceride secretion (TGSR) into plasma determined (Triton). Animals treated with fluoxymesterone demonstrated significantly lower TG (less than 0.05) and no alteration in TGSR. These findings are consistent with other observations which suggest that the triglyceride-lowering effect of androgens results from an accelerated rate of removal of triglyceride-rich lipoproteins from plasma.

The effect of orally administered androgens on sperm motility

The administration of oral androgens increased sperm motility to normal in 30 (52%) of 58 men whose impaired motility was the only defect in their semen quality. Their ejaculate volume, sperm count, and morphology were not benefited. Suppression was infrequently seen and appeared to be transient. Pregnancies were documented in 15 (26%) of the 58 couples studies. However, communication regarding this matter was made with only 39 of the 58 couples. The benefical effect from a single course of androgen is likely to persist. However, if a pregnancy does not ensue, semen analysis should be repeated to determine if additional medication is necessary. Pretreatment serum testosterone determinations were not helpful in determining those men who would most likely benefit from therapy. No appreciable benefit was noted in the semen quality of the 35 subfertile men identically treated who, in addition to poor sperm motility, had other defects in their semen.

Ancillary measures in treatment of myeloma. Use of immune serum globulin, fluoride, or androgen

We reviewed the efficacy of three agents advocated as ancillary therapy in myeloma patients. Intramuscularly administered immune serum globulin (gamma globulin) was ineffective in preventing infection. Hemoglobin level was improved in some myeloma patients receiving androgens. However, the response rate and the degree of leukopenia or thrombocytopenia were not superior with androgen-melphalan-prenisone combination therapy, as compared with those resulting from the two-drug combination without androgen. A controlled study evaluating androgen plus melphalan has not been done. The long-term administration of fluoride, supplemented by calcium and androgen, induced radiologically apparent bone fluorosis, but strengthening of lytic bone was not observed. Neither objective nor subjective benefit was demonstrated in a controlled study comparing the effects of fluoride (without calcium supplement) with those of the placebo.

Treatment of myeloma. Comparison of melphalan, chlorambucil, and azathioprine

A randomized study compared the response of patients with multiple myeloma to chlorambucil, melphalan, and azathioprine. All patients also received a combination of prednisone and fluoxymesterone. Seventy-three of 86 patients entered on the study could have evaluations. The results indicate that melphatan produced more responses than either azathioprine or chlorambucil, but responses to both of these agents were observed. No difference was noted between survival curves for patients with no poor-risk factors as compared to those having at least one poor-risk factor. The only poor-risk factor affecting survival in this group of patients was the blood urea nitrogen level.