Good Quality 66.7% 5-year Overall Survival in Terminal Lung Cancer Patients Treated With Mifepristone.

[BACKGROUND/AIM] There have been several anecdotal case reports documenting marked palliative benefits following treatment of terminal patients suffering from a variety of different types of cancer with the single agent selective progesterone receptor modulator (SPRM) mifepristone including stage IV treatment refractory small cell lung cancer (SCLC) and stage IV non-small cell lung cancer (NSCLC). The proposed mechanism of action is to suppress the production of immunomodulatory proteins that are the result of activating membrane progesterone receptors (mPRs). Case reports showing efficacy of a given therapy show that this type of treatment can be effective but gives the reader no indication as to whether that therapy is effective in just some rare cases or if it can provide benefit to a majority of cases.

[CASE REPORT] Although a randomized controlled trial or a multicentered large series would be ideal, we waited until all of the six cases of very advanced treatment refractory stage IV lung cancer that we treated (two with SCLC, four with NSCLC) either died or survived five years taking single agent oral mifepristone. The dosage was either 200 or 300 mg/day. A 66.7% good quality 5-year overall survival ensued with death generally from co-morbidities not the lung cancer itself.

[CONCLUSION] The likelihood of this type of response occurring by chance is extremely low. It is hoped that this report will encourage oncologists, scientists, and clinicians to further investigate the use of SPRMs in a larger cohort of patients with stage IV lung cancer, and potentially in those with less advanced disease.