Mifepristone (abortion pill)
The first patient, a 71-year-old retired bus driver who lives in New York City, was diagnosed in 2013 with lung cancer that had spread to his bladder. Surgery and chemo helped for two years, when a small brain metastasis was detected. He wasn’t a candidate for a checkpoint inhibitor, so his oncologist suggested Check’s trial.
“In 2016, I started mifepristone,” said the patient, who drives to Melrose Park once a month for monitoring tests. “The lung lesions are stable. There’s no further evidence of metastases in the brain. I have no shortness of breath. No side effects whatsoever.”
The second patient, a 69-year-old woman from South Jersey, already had debilitating pulmonary disease from years of smoking when she was diagnosed with late-stage lung cancer in 2014. After chemo, two targeted drugs, and a checkpoint inhibitor failed to control it, her Voorhees oncologist, Trina Poretta, told her about the trial.
In April, with her cancer stable for more than 19 months, she said, “You take a pill once a day at the same time. That’s pretty much it. You can eat anything. I’ve had no headaches, no nausea.”
Although her cancer has not progressed, her pulmonary disease has worsened to the point where she is now receiving hospice care.
This study of 34 ovarian cancer patients treated with Mifepristone says:
Nine (26.5%) of these patients had a response to Mifepristone. Three(9%) patients had a complete response, and six (17.5%), a partial response. The response of one patient in each group was measured by CA-125 levels while the remainder had measurable disease. The response lasted 1 to 4 months in all but one patient. One patient continues to respond after more than 3 years. The major toxic effect was a rash and this was the major reason patients were removed from the study.
Conclusion: Mifepristone has activity against ovarian cancer resistant to cisplatin and paclitaxel. The drug is well tolerated.
This study says: Major clinical problems in the treatment of ovarian cancer include the resistance to current therapy, the elevated toxicity of standard drugs, and the repopulation of cells that escape chemotherapy. Therefore, the development of novel strategies for ovarian cancer treatment is of significant importance. In this report, we demonstrate that the contraceptive steroid mifepristone is a potent cytostatic agent to human ovarian cancer cells of different genetic backgrounds, inducing cell cycle arrest and blocking the G1-to-S phase transition.
In summary, we have shown that mifepristone is a potent blocker of ovarian cancer growth in vitro and in vivo. The feasibility of using mifepristone to enhance the efficacy of conventional chemotherapy for ovarian cancer is encouraging and requires further investigation.
Cancer stem cells
Study: In conclusion, MIF [Mifepristone] inhibits basal TNBC cell growth in vitro…and induces the expression of miR-153 to suppress the expression of KLF5, which promotes basal TNBC [Triple-Negative Breast Cancer] cell proliferation, survival and CSC [cancer stem cells] maintenance.
Long-term High-quality Survival
Case Report: We show long-term high-quality survival following single-agent treatment with a progesterone receptor antagonist in two cases of advanced metastatic cancer. Because no biopsy was performed (patient refused) the exact type of lung cancer was not determined but the majority of oncologists who evaluated the patient thought that the rapid onset and syndrome of inappropriate anti-diuretic hormone was more consistent with small-cell lung cancer. The US Food and Drug Association granted a compassionate-use investigational new drug approval for use of single-agent 200 mg mifepristone orally/day to a moribund woman with never-treated metastatic lung cancer and a male with bilateral renal cell carcinoma who had undergone only a unilateral hemi-nephrectomy. Both had long-term high-quality survival (5 years for the patient with lung cancer with complete remission of all lung lesions, and 12 years for the male patient with kidney cancer). Neither patient had any side-effects from mifepristone therapy. Conclusion: These cases helped influence the US Food and Drug Association in granting an investigator-initiated investigational new drug study on advanced non-small cell lung cancer.