Faculty Collaboration Database

Systemic chemotherapy for adrenocortical carcinoma: comparative responses to conventional first-line therapies. Anticancer Drugs 2008 Jul;19(6):637-44

Date

06/06/2008

Pubmed ID

18525324

DOI

10.1097/CAD.0b013e328300542a

Scopus ID

2-s2.0-53749087386 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

The objective of this study was to evaluate and compare the efficacies of conventional first-line chemotherapies for adrenocortical carcinoma. We reviewed the records of adult patients (> or =17 years) who had received first-line systemic chemotherapy with serial pretreatment and posttreatment radiologic staging studies in our institution between 1980 and 2000. Overall survival (OS) and time to progression (TTP) for different treatment groups were determined using the Kaplan-Meier method and were compared using the log-rank test. Univariate and multivariate models were fitted to different subsets of patients for OS and TTP and used to calculate hazard ratios (HRs) with 95% confidence intervals. We identified 224 patients with a diagnosis of adrenocortical carcinoma, 57 of whom met the inclusion criteria for further study. Chemotherapy groups included: mitotane (n=12), platinum and etoposide (n=16), mitotane with platinum and etoposide (n=11), mitotane and other cytotoxics (n=5), platinum and etoposide with other cytotoxics (n=3), and other miscellaneous cytotoxics (n=10). No statistically significant differences in OS (P=0.31) were noted among the treatment groups, but there was a statistically significant difference in TTP (P=0.02) favoring mitotane alone (TTP=6.24 months; 95% confidence interval, 3.58-32.13). Multivariate analysis was most notable for a significantly greater OS (HR=0.49, P=0.04) and TTP (HR=0.3, P=0.01) associated with peritoneal metastases. Our analysis revealed no clear advantage for any single agent or combination over any of the other conventional frontline chemotherapeutic choices for adrenocortical carcinoma. Novel agents are thus sorely needed in the treatment of this aggressive cancer.

Author List

Fareau GG, Lopez A, Stava C, Vassilopoulou-Sellin R

Author

Gilbert G. Fareau MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adrenocortical Carcinoma
Adult
Antineoplastic Combined Chemotherapy Protocols
Cisplatin
Disease Progression
Etoposide
Female
Humans
Male
Middle Aged
Mitotane
Regression Analysis