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September 8, 1975

Medical Adrenalectomy With Aminoglutethimide-Reply

Author Affiliations

Milton S. Hershey Medical Center Pennsylvania State University Hershey

JAMA. 1975;233(10):1047-1048. doi:10.1001/jama.1975.03260100017007

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In Reply.—  Drs. Corder and Flannery raise several points that require comment. First, they state that the previous studies cited by us, detailed by them in the Table, fail to establish the efficacy of large doses of glucocorticoids in the treatment of breast carcinoma. However, 117 of 467, or 25%, of patients listed in this Table were classified as "objective" responders. While these studies were carried out over the past two decades and did not use now-accepted criteria for objective responses, sufficient documentation is available in several of these references to establish the efficacy of glucocorticoids using current criteria. As mentioned in our "Comment" section, we would agree that these studies suggest that "glucocorticoid-induced adrenal suppression probably results in a lower remission rate than with surgical adrenalectomy."In regard to the response data cited for aminoglutethimide, all of our patients classified as 1A responders experienced at least a measurable 50%