Article: PDF OnlyTherapy for metastatic breast cancerRubens, Robert D. MDAuthor Information Guy's Hospital, London, UK Current Opinion in Oncology: November 1994 - Volume 6 - Issue 6 - p 578-582 Buy Abstract Our understanding of mechanisms of resistance to endocrine treatment has increased; they include mutations in steroid receptors and altered metabolism of tamoxifen. Tamoxifen and progestogens appear to have similar efficacies for first-line endocrine treatment, but high doses of progestogens have been shown to give less cost-effective results compared with conventional doses. Numerous new endocrine and cytotoxic agents have been reported, but no major new treatments have been identified. High-dose chemotherapy for metastatic disease remains experimental. The concept of estrogen recruitment to enhance chemosensitivity has not been corroborated. Prior adjuvant systemic treatment renders treatment of relapsed breast cancer less effective. © Lippincott-Raven Publishers.