Combination Chemotherapy in Advanced Adrenocortical Carcinoma

In this large international study of patients with adrenal cancer, a rare, treatment-refractory disease, mitotane plus a combination of etoposide, cisplatin, and doxorubicin had greater antitumor activity than mitotane plus streptozotocin. Adrenocortical carcinoma is a rare cancer (estimated inciden...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 366; no. 23; pp. 2189 - 2197
Main Authors: Fassnacht, Martin, Terzolo, Massimo, Allolio, Bruno, Baudin, Eric, Haak, Harm, Berruti, Alfredo, Welin, Staffan, Schade-Brittinger, Carmen, Lacroix, André, Jarzab, Barbara, Sorbye, Halfdan, Torpy, David J, Stepan, Vinzenz, Schteingart, David E, Arlt, Wiebke, Kroiss, Matthias, Leboulleux, Sophie, Sperone, Paola, Sundin, Anders, Hermsen, Ilse, Hahner, Stefanie, Willenberg, Holger S, Tabarin, Antoine, Quinkler, Marcus, de la Fouchardière, Christelle, Schlumberger, Martin, Mantero, Franco, Weismann, Dirk, Beuschlein, Felix, Gelderblom, Hans, Wilmink, Hanneke, Sender, Monica, Edgerly, Maureen, Kenn, Werner, Fojo, Tito, Müller, Hans-Helge, Skogseid, Britt
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 07.06.2012
Subjects:
Adrenal Cortex Neoplasms - drug therapy
Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
Adrenocortical Carcinoma - drug therapy
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Cancer therapies
Chemotherapy
Cisplatin
Cisplatin - administration & dosage
Cytotoxicity
Disease-Free Survival
Doxorubicin
Doxorubicin - administration & dosage
Drug dosages
Endocrinopathies
Etoposide
Etoposide - administration & dosage
Female
General aspects
Hospitals
Humans
Intention to Treat Analysis
Kaplan-Meier Estimate
Male
Malignant tumors
Medical prognosis
Medical sciences
Metastasis
Middle Aged
Mitotane - administration & dosage
Mitotane - adverse effects
Neuroendocrine tumors
Patients
Population
Quality of Life
Response rates
Streptozocin
Streptozocin - administration & dosage
Streptozocin - adverse effects
Survival
Tumors
Young Adult
Germany
Endocrinopathy
Medicine
Adrenal cortex carcinoma
Drug combination
Adrenal gland diseases
Advanced stage
Combined treatment
Malignant tumor
Cancer
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In this large international study of patients with adrenal cancer, a rare, treatment-refractory disease, mitotane plus a combination of etoposide, cisplatin, and doxorubicin had greater antitumor activity than mitotane plus streptozotocin. Adrenocortical carcinoma is a rare cancer (estimated incidence, 0.7 to 2.0 cases per 1 million population per year) 1 , 2 with a poor prognosis; the 5-year survival rate is less than 15% among patients with metastatic disease. 3 – 7 Mitotane is the only drug approved for the treatment of adrenocortical carcinoma and is used both as adjuvant therapy and for advanced disease, 8 – 14 although its efficacy has never been shown in a randomized trial. The experience with other antineoplastic drugs for the treatment of this disease is even more limited. Current treatment strategies for advanced disease are based exclusively on retrospective series . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1200966