Mitotane With or Without Cisplatin and Etoposide for Patients with a High Risk of Recurrence in Stages 1–3 Adrenocortical Cancer After Surgery

Sarvestani, Amber Leila; Gregory, Stephanie N; Teke, Martha E.; Terzolo, Massimo; Berruti, Alfredo; Hernandez, Jonathan M.; Habra, Mouhammed Amir

doi:10.1245/s10434-022-12725-4

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Currently, the management of patients with ACC includes surgery followed by adjuvant therapies (e.g., mitotane, radiotherapy or platin-based therapy) or active surveillance in a subset of low-risk patients with localized disease [ 1 , 7 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. Treatment of recurrent disease is usually individualized [ 31 ] whereas in advanced disease, mitotane ± chemotherapy are the cornerstones of therapy [ 32 , 33 , 34 ].…”

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confidence: 99%

Early Detection of Recurrence and Progress Using Serum Steroid Profiling by LC–MS/MS in Patients with Adrenocortical Carcinoma

Kimpel,

Altieri,

Dischinger

et al. 2023

Metabolites

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Serum liquid chromatography–tandem mass spectrometry (LC–MS/MS) steroid profiling is used for the diagnosis of adrenocortical carcinoma (ACC). Guidelines recommend endocrine work-up in addition to radiological imaging for follow-up in ACC, but data on this topic are scarce. Patients were included in this retrospective study if pre-therapeutic hormone values, regular tumour evaluation by imaging, steroid measurements by LC–MS/MS, and details on therapies were available. The utility of steroid profiles in detecting recurrence or disease progression was assessed, whereby “endocrine progress” was defined by an elevation of at least 3 of 13 analysed hormones. Cohort A included 47 patients after R0 resection, of whom 15 experienced recurrence and 32 did not. In cohort B, 52 patients with advanced disease (including 7 patients of cohort A with recurrence) could be evaluated on 74 visits when progressive disease was documented. In 20 of 89 cases with documented disease progression, “endocrine progress” was detectable prior to radiological progress. In these cases, recurrence/progression was detected at a median of 32 days earlier by steroid measurement than by imaging, with 11-deoxycortisol and testosterone being the most sensitive markers. Notably, these patients had significantly larger tumour burden. In conclusion, steroid profiling by LC–MS/MS is of value in detecting recurrent/progressive disease in ACC.

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