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September 26, 1977

Diethylstilbestrol in Breast Cancer: Dose-Response Analysis

Author Affiliations

Hunter College of the City University of New York
Memorial Sloan-Kettering Cancer Center New York

JAMA. 1977;238(13):1362-1363. doi:10.1001/jama.1977.03280140040006

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To the Editor.—  Carter et al have recently published in this journal (237:2079, 1977) the results of a cooperative, prospective, double-blind study that attempted to assess the role of diethylstilbestrol (DES) in the treatment of postmenopausal women with metastatic breast cancer. These investigators studied the dose-response characteristics of this drug over a fourlog dosage range. The data obtained in the study, when analyzed according to a mathematical model of doseresponse, led to the following conclusions:

  1. The response rate to DES is a function not only of the dose but also of menopausal age and dominant site of metastases.

  2. However, the results within menopausal age group and within dominant metastatic site category do not conform to a simple, uniformly increasing dose-response relationship. In particular, for the postmenopausal age group of ≥5 and ≤10 years the analysis led to a complex relationship in which the "best treatment" varied according to site