Objective: To describe the clinical and biochemical features of patients in whom adrenal insufficiency developed during megestrol acetate therapy for advanced breast cancer.
Patients and methods: Thirteen patients with advanced breast cancer treated with oral megestrol acetate, 160 mg/d.
Results: Fatigue and weakness were observed in all 13 patients. Hypotension was observed in 8. Anorexia, nausea, vomiting, and diarrhea were observed in 3. Mean basal cortisol level at the time of symptoms was 41.4 nmol/L (range, 27.6-110.4 nmol/L). After corticotropin stimulation, mean cortisol level at 30 minutes was 239.2 nmol/L (range, 93.8-447.0 nmol/L); at 60 minutes, 228.2 nmol/L (range, 88.3-474.5 nmol/L).
Conclusion: Megestrol therapy was associated with the development of clinical adrenal insufficiency in our patients, as proved by rapid corticotropin test.