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A review of mitotane in the management of adrenocortical cancer.
A review of mitotane in the management of adrenocortical cancer. The oncologist Del Rivero, J., Else, T., Hallanger-Johnson, J., Kiseljak-Vassiliades, K., Raj, N., Reidy-Lagunes, D., Srinivas, S., Gilbert, J., Vaidya, A., Aboujaoude, E., Bancos, I., Tito Fojo, A. 2024Abstract
IMPORTANCE: Mitotane (Lysodren, o,p'-DDD [1-(o-chlorophenyl)-1-(p-chlorophenyl)-2,2-dichloroethane)] is currently the only United States Food and Drug Administration and European Medicines Agency-approved product for the treatment of adrenocortical carcinoma.OBSERVATIONS: Mitotane is challenging to administer; however, its toxicities (specifically adrenal insufficiency) are well known, and the management of adverse consequences has established approaches. While often viewed through the prism of a cytotoxic agent, it can also interfere with hormone production making it a valuable asset in managing functional ACC. A recently completed prospective trial has shed some light on its use in the adjuvant setting, but further clarity is needed. Many think mitotane has a role in the advanced or metastatic setting, although prospective data are lacking and retrospective analyses are often difficult to interpret.CONCLUSIONS AND RELEVANCE: When used carefully and thoughtfully, especially in patients with hormonal excess, mitotane is an important component of the treatment armamentarium for ACC.
View details for DOI 10.1093/oncolo/oyae084
View details for PubMedID 39037424