The CancerWeb Report, What's New In Cancer: September, 1996
Liver Cancer

• Type of estrogen receptor as a guide to hormone treatment - Liver cancers occurring in patients with cirrhosis of the liver are frequently not treatable by surgery. Since liver tumors commonly show some dependence on estrogens through having receptors for binding them, the antiestrogen tamoxifen has often been given to help reduce tumor size, but it only works in a minority of patients. A report from the University of Modena in Italy, appearing in the September 1, 1996 issue of Cancer Research, helps explain why this is, and also suggests a different approach to treatment that might be effective. There are two types of estrogen receptor, the normal one and a variant form which does not bind the female hormone estradiol. The variant form is found more often than the normal receptor in liver cancers. Since tamoxifen needs to react with the receptor to block the action of estradiol, most liver cancers which have the variant receptor will not respond to tamoxifen. The small study described used only eight patients, but it was clear that those patients with normal receptor responded to tamoxifen, whereas the tumors with variant receptor only shrank in size in response to another antiestrogen, megestrol, that does not need the estrogen receptor for its action. The work needs confirmation by other research, but it strongly suggests that preliminary determination of the type of receptor present in the tumor should be done as a valuable indicator of which type of hormone therapy to use. (Villa, Cancer Res 56:3883, 1996)