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o,p′‐DDD (mitotane) therapy of adrenal cortical carcinoma. Observations on drug dosage, toxicity, and steroid replacement
Author(s) -
Hogan T. F.,
Citrin D. L.,
Johnson B. M.,
Nakamura S.,
Davis T. E.,
Borden E. C.
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197811)42:5<2177::aid-cncr2820420514>3.0.co;2-x
Subject(s) - mitotane , medicine , toxicity , adrenocortical carcinoma , carcinoma , drug , adrenal insufficiency , chemotherapy , endocrinology , gastroenterology , pharmacology
Four patients with adrenal cortical carcinoma were treated with standard doses of o,p′‐DDD. Plasma levels of o,p′‐DDD and its metabolites o,p′‐DDA and o,p′‐DDE were measured. o,p′‐DDD was measurable for up to 8 months after stopping therapy, and trace levels of metabolites were detectable at 18 months. Although 2 of 3 patients with measurable disease had objective tumor response and one patient achieved a complete response, severe drug toxicity occurred in all patients and signs of adrenal insufficiency occurred in three. Low dose therapy with o,p′‐DDD is suggested, together with full gluco and mineralo‐corticoid replacement. Measurement of o,p′‐DDD and its metabolites in plasma may prove clinically useful in developing effective but less toxic dosage schedules. Cancer 42:2177–2181, 1978.