Mitotane Associated With Cisplatin, Etoposide, and Doxorubicin in Advanced Childhood Adrenocortical Carcinoma

Abstract

Mitotane daily dose to maintain TL is variable and monitoring should start 1.5 months after the beginning of treatment. CED combined with mitotane is the best available pharmacologic treatment for ACC, but further studies are required to characterize different profiles of therapeutic response.

Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline

“…The FDA issued a black box warning for this in 2013, and the European Medicines Agency has restricted access to the agent to physicians specialized in treating CS (125). Among 33 cases of potential ketoconazole-induced liver injury submitted to the FDA from the time of initial marketing in 1980, 18 patients had an 8-fold elevation in transaminases, five had cholestatic injury, and nine had a mixture of the two (126).…”

Gene Expression Profiling of Childhood Adrenocortical Tumors

“…However, in many cases, clinical and pathologic features fail to identify patients with localized disease that eventually relapse. Current therapy for pediatric ACT primarily relies on surgical resection of the tumor, although mitotane (a DDT-related compound)-with or without DNA-damaging agents-has been used with some success (3). The overall 5-year disease-free survival is 50%; however, patients with stage IV disease have less than a 10% chance of long-term survival (2).…”

Uncovering p53 Mutations and Abnormal Gene Expression in Pediatric Adrenocortical Cancer

“…Overall structural functions of the p53 domains include maintaining stability ; shown in red), tetramerization domain (amino acids 326-355; shown in green), and the basic C-terminal domain (amino acids 363-393; shown in yellow). The protein is also comprised of five structurally conserved domains: I (amino acids [13][14][15][16][17][18][19][20][21][22][23], II (amino acids , III (amino acids [171][172][173][174][175][176][177][178][179][180][181], IV (amino acids 234-258), and V (amino acids 270-286). …”