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Mitotane may increase survival in adrenocortical carcinoma
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Adults with adrenocortical carcinoma treated with mitotane after radical resection of the tumor may have increased recurrence-free survival and overall survival compared with untreated adults, study data show.
Alfredo Berruti, MD, of the department of medical and surgical specialties, radiological sciences and public health at the University of Brescia, Spedali Civili Hospital in Italy, and colleagues evaluated data from 162 adults with adrenocortical carcinoma to determine the effect of adjuvant mitotane on recurrence-free survival during 9 years of follow-up.
Participants were assigned to adjuvant mitotane (Lysodren, Bristol-Myers Squibb; n = 47), no adjuvant therapy (control group 1; n = 45) or no treatment after surgery (control group 2; n = 70).
Recurrence was observed in 53% of the mitotane group, 89% of control group 1 and 80% of control group 2. Death occurred in 49% of the mitotane group, 90% of control group 1 and 59% of control group 2.
Recurrence-free survival was longer in the mitotane group (42 months) compared with control group 1 (17 months; P < .001) and control group 2 (26 months; P = .005). Similarly, median overall survival was longer in the mitotane group (161 months) compared with control group 1 (65 months; P = .007) and control group 2 (92 months; P = .28).
Compared with the mitotane group, the risk for recurrence was higher in control group 1 (P < .0001) and control group 2 (P < .0001). Similarly, the risk for death was higher in control group 1 (P = .011) and control group 2 (P = .083) compared with the mitotane group.
“We think that the present results strengthen the recommendation of adjuvant mitotane as part of the postoperative management of [adrenocortical carcinoma] patients,” the researchers wrote. “Another important finding is that an aggressive use of surgery to treat [adrenocortical carcinoma] recurrences may be associated with prolonged survival. Repeat surgery for recurrent [adrenocortical carcinoma] may provide a benefit in overall survival independently from mitotane use. These data are of particular interest for surgeons operating on [adrenocortical carcinoma] patients, who should refer these patients to centers with specific expertise on surgical treatment of [adrenocortical carcinoma] and management of mitotane therapy.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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