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September 8, 1975

Medical Adrenalectomy With Aminoglutethimide

Author Affiliations

Letterman Army Medical Center, Presidio of San Francisco

JAMA. 1975;233(10):1047. doi:10.1001/jama.1975.03260100017006

To the Editor.—  The recent article by Santen et al (230:1661, 1974) is certainly an excellent and useful contribution in regard to the pharmacology of aminoglutethimide and dexamethasone interaction. There are, however, points that deserve comment. The authors state that large doses of glucocorticoids are established in the treatment of breast cancer. A review of 12 of the cited references fails to establish either the efficacy or the dose response relationship of glucocorticoids (Table).1-12 In addition, the cited studies did not utilize the now accepted criteria of objective partial remission, ie, greater than or equal to 50% reduction in the product of the two greatest diameters of palpable or measurable lesions.In regard to the response data cited for aminoglutethimide, the earlier series did achieve objective partial remissions in three of nine cases.13 However, of the 22 patients reported by the authors of the current study, there were