Research Papers:

Colorectal tumor prevention by the progestin medroxyprogesterone acetate is critically dependent on postmenopausal status

Bartolomeus J. Meijer, Mattheus C.B. Wielenga, Patricia B. Hoyer, James M. Amos-Landgraf, Theodorus B.M. Hakvoort, Vanesa Muncan, Jarom Heijmans and Gijs R. van den Brink _

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Oncotarget. 2018; 9:30561-30567. https://doi.org/10.18632/oncotarget.25703

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Bartolomeus J. Meijer1,*, Mattheus C.B. Wielenga1,*, Patricia B. Hoyer3, James M. Amos-Landgraf4, Theodorus B.M. Hakvoort1, Vanesa Muncan1, Jarom Heijmans1,2 and Gijs R. van den Brink1,2,5

1Tytgat Institute for Liver and Intestinal Research and Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands

2Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

3Department of Physiology, University of Arizona, Tucson, AZ, USA

4Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, USA

5GlaxoSmithKline, Medicines Research Center, Stevenage, UK

*These authors have contributed equally to this work

Correspondence to:

Gijs R. van den Brink, email: [email protected]

Keywords: colon cancer; chemoprevention; animal models; menopause; hormone replacement

Received: January 30, 2018     Accepted: June 01, 2018     Published: July 17, 2018


The large randomized placebo controlled trials of the Women’s Health Initiative have shown that the combination of estrogen and progestin medroxyprogesterone acetate (MPA) protects from colorectal cancer in postmenopausal women. No effect was observed in women treated with estrogen alone. This suggests that progesterone, or more specifically the progestin MPA may have chemopreventive activity. The effect of MPA on colorectal carcinogenesis has been difficult to study in animal models. Most models are not affected by either depleting female hormones by ovariectomy or treatment with MPA. Importantly, an ovariectomy fails to reproduce one of the hall marks of the postmenopausal state in women with intact ovaries. That is, the continued production of androgens by the atrophic postmenopausal ovaries. Here we show that adenoma incidence is increased in the vinyl cylcohexene diepoxide (VCD) mouse model of the menopause compared to age matched fertile female mice. Treatment with MPA protected VCD treated mice from adenomagenesis, but had no effect on adenoma numbers in age-matched fertile female mice. Our data show that the protective effect of MPA depends on the postmenopausal state and suggest that MPA monotherapy may be studied as a chemopreventive agent in postmenopausal women.

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