Adenocarcinoma of the pancreas--a hormone sensitive tumor? A preliminary report on Nolvadex treatment

Abstract

There are indications of possible effects of sex hormones on the pancreas. These include reports on steroid receptor proteins in pancreatic tissue, the purification and characterization of a highly specific, high capacity oestrogen binding protein in the human pancreas and capacity of human pancreatic tissue to convert the main peripheral oestrogen, oestrone sulphate, into the terminal biologically active oestradiol-17 beta. Furthermore, experiments in mice have shown accumulation of an anti-oestrogen, tamoxifen, in the pancreas. With this background, we have tried tamoxifen in 14 patients with unresectable adenocarcinoma of the pancreas. The median survival time was 8.5 months and three patients had a remarkably long survival time of 22 months. In a historical control group the median survival time was 2.5 months and no patients survived for more than 21 months. We have therefore started a randomized trial with tamoxifen in patients with unresectable pancreatic cancer. Even if anti-oestrogens are not the optimal form of therapy, other sorts of hormonal manipulation ought to be tried in pancreatic cancer.