Impact of monitoring plasma 1,1-dichlorodiphenildichloroethane (o,p?DDD) levels on the treatment of patients with adrenocortical carcinoma

Abstract

A super‐site‐selective micropattern of TiO2 on a flexible polymer substrate (see Figure) has been achieved by utilizing a barrier‐effect self‐assembly process. The TiO2 micropattern is useful as a UV filter for nanodevices in integrated electronic and optical circuits.

Combination Chemotherapy in Advanced Adrenocortical Carcinoma

“…Several small studies have suggested that the antineoplastic activity of mitotane monotherapy is increased at blood drug levels of 14 mg per liter or higher. 8,9,24 In our study, only 54 patients had such blood mitotane levels at the time of enrollment, with a similar distribution in the two study groups. Thus, any antitumor activity of mitotane is unlikely to have been a major confounder of the observed first-line efficacy of the EDP-mitotane regimen.…”

“…[3][4][5][6][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][9][10][11][12][13][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.…”

“…8,9 Since adjuvant mitotane therapy is frequently used in patients with adrenocortical carcinoma, 10 previous treatment with mitotane before study entry was allowed. Concomitant medications and therapies that were deemed to be necessary for the supportive care and safety of the patients were also allowed at the discretion of the local investigators.…”

Mitotane levels predict the outcome of patients with adrenocortical carcinoma treated adjuvantly following radical resection

“…Mitotane was given orally following a schedule of progressive dose increments according to local protocols and patient compliance aiming to reach concentrations between 14 and 20 mg/l (14,15). When such or even higher concentrations were attained, doses were tapered with further individual dose adjustments guided by the results of mitotane measurement and toxicity assessment.…”

“…Indeed, mitotane plasma levels have been shown to be associated with both therapeutic efficacy and drugrelated toxicity in advanced ACC (14,15) and a recent study has confirmed that a mitotane concentration above 14 mg/l is a predictor of tumor response and better survival (16). A similar strategy of targeting a threshold of 14 mg/l has been advocated in the adjuvant setting, despite the fact that it is presently unknown if the relationship between plasma concentrations of mitotane and its efficacy is applicable also to patients treated adjuvantly without evidence of disease (13,17).…”