Advanced adrenocortical carcinoma successfully treated with gemcitabine plus capecitabine as second‐line chemotherapy

Abstract

Introduction: Adrenocortical carcinoma is a rare malignant tumor with an unfavorable prognosis in the advanced stage for which second-/third-line chemotherapy is not well established. Case presentation: A 34-year-old woman was referred to our institution for left adrenal tumor with multiple liver metastases and tumor thrombus extending to the inferior vena cava. According to her clinical diagnosis of adrenocortical carcinoma (T4N0M1, European Network for the Study of Adrenal Tumors stage IV), we resected the left adrenal tumor and tumor thrombus. Pathological examination confirmed the adrenocortical carcinoma diagnosis. After four courses of etoposide, doxorubicin, cisplatin, and mitotane therapy, the liver metastases progressed, and we started gemcitabine, capecitabine, and mitotane therapy as second-line chemotherapy. After 7 months, significant shrinkage of the liver metastases was observed, and they remained stable over 16 months. Conclusion: We reported a case of advanced adrenocortical carcinoma with significant shrinkage of liver metastases following gemcitabine, capecitabine, and mitotane therapy, with the effect maintained over 16 months.

Phase II study of cabazitaxel as second-third line treatment in patients with metastatic adrenocortical carcinoma

“…The combination of capecitabine and gemcitabine and single agent temozolomide are the only cytotoxic therapies that have demonstrated some activities in this setting. Despite few cases showing exceptional benefits, 33 , 34 however, disease responses to these treatments were rarely observed and were of short duration.…”

Editorial Comment to Advanced adrenocortical carcinoma successfully treated with gemcitabine plus capecitabine as second‐line chemotherapy

“…Yamamoto et al . presented the case of a patient with advanced adrenocortical carcinoma (ACC) who was treated successfully with gemcitabine, capecitabine, and mitotane (GC‐M) therapy after etoposide, doxorubicin, cisplatin, and mitotane (EDP‐M) therapy 1 …”

“…The First International Randomized Trial in Locally Advanced and Metastatic Adrenocortical Carcinoma Treatment demonstrated improved progression‐free survival (PFS) in patients treated with EDP‐M therapy compared to patients treated with streptozotocin plus mitotane 3 . EDP‐M therapy was generally accepted as the current first‐line treatment for advanced ACC on the basis of the results of this trial 1 . Second‐line treatment for advanced ACC, however, is not well established.…”

“…The case report by Yamamoto et al . presents a presented with advanced ACC who was treated with GC‐M therapy as a second‐line treatment and achieved long‐term disease control 1 . In an earlier study, Henning et al .…”