ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2026
A forgotten option: megestrol acetate's effectiveness and safety in HR+/HER2-negative metastatic breast cancer - insights from a contemporary patient cohort.
Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The ABC 6/7 guidelines recommend megestrol acetate (MA) as a later-line hormonal option for HR+/HER2- metastatic breast cancer (MBC) when targeted therapies are unavailable, though current evidence on its efficacy and safety remains limited. Materials and methods: This retrospective study assessed the effectiveness and tolerability of MA (200-400 mg) in HR+/HER2- MBC patients treated at the reference Cancer Center in Poland (January 2020-December 2024). Patients on other systemic therapies or with active malignancies were excluded. Median progression-free survival (mPFS) and overall survival (mOS) were assessed using Kaplan-Meier estimates and Cox proportional hazards models. Statistical significance was defined as p < 0.05. Results: The study included 20 patients (median age: 70.2 years; range: 49.5-92.4) with a median follow-up of 4.5 months [interquartile range (IQR): 0.34-9.99]. Patients had received a median of 2.5 prior systemic therapies (IQR: 1-5) and 2 prior hormonal therapy lines (IQR: 0-4). Eleven patients (55.0%) had exhausted hormonal options, and eleven (55.0%) were ineligible for chemotherapy, including eight (40.0%) with no other systemic treatment options. mPFS was 2.6 months [95% confidence interval (CI): 1.37-4.32], and mOS, 4.1 months (95% CI: 1.5-10.8). Performance status 2-4 was associated with higher risk of progression or death [hazard ratio (HR) = 2.75] and death (HR = 9.42) Conclusions: Despite the small sample size, the observed outcomes support the continued inclusion of MA in ABC guidelines for the treatment of HR+/HER2- MBC, further substantiated by the comprehensive review of clinical evidence and recommendations presented in this article.
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