Mifepristone as treatment of recurrent progesterone receptor-positive uterine leiomyosarcoma.

Abstract

Prolonged treatment with antiprogestin results in shrinkage of benign uterine leiomyomata. Leiomyomata and uterine leiomyosarcomas share some common features, and they both often express progesterone receptors. Thus, treatment of uterine leiomyosarcomas with antiprogestins has been suggested. The antiprogestin mifepristone was administered (50-200 mg/d) to three patients with recurrent uterine leiomyosarcomas. A dramatic response lasting more than 3 years was observed in a case of recurrent low-grade (G1) progesterone receptor-positive leiomyosarcomas. In two other patients, with G3 leiomyosarcomas, the disease progressed despite several months of mifepristone therapy. We speculate that mifepristone has a role in the management of some cases of recurrent uterine leiomyosarcomas.