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  • Fassnacht, Martin (author)

Combination chemotherapy in advanced adrenocortical carcinoma

  • Article/chapterEnglish2012

Publisher, publication year, extent ...

  • 2012
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-175725
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175725URI
  • https://doi.org/10.1056/NEJMoa1200966DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:124695113URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND:Adrenocortical carcinoma is a rare cancer that has a poor response to cytotoxic treatment.METHODS:We randomly assigned 304 patients with advanced adrenocortical carcinoma to receive mitotane plus either a combination of etoposide (100 mg per square meter of body-surface area on days 2 to 4), doxorubicin (40 mg per square meter on day 1), and cisplatin (40 mg per square meter on days 3 and 4) (EDP) every 4 weeks or streptozocin (streptozotocin) (1 g on days 1 to 5 in cycle 1; 2 g on day 1 in subsequent cycles) every 3 weeks. Patients with disease progression received the alternative regimen as second-line therapy. The primary end point was overall survival.RESULTS:For first-line therapy, patients in the EDP-mitotane group had a significantly higher response rate than those in the streptozocin-mitotane group (23.2% vs. 9.2%, P<0.001) and longer median progression-free survival (5.0 months vs. 2.1 months; hazard ratio, 0.55; 95% confidence interval [CI], 0.43 to 0.69; P<0.001); there was no significant between-group difference in overall survival (14.8 months and 12.0 months, respectively; hazard ratio, 0.79; 95% CI, 0.61 to 1.02; P=0.07). Among the 185 patients who received the alternative regimen as second-line therapy, the median duration of progression-free survival was 5.6 months in the EDP-mitotane group and 2.2 months in the streptozocin-mitotane group. Patients who did not receive the alternative second-line therapy had better overall survival with first-line EDP plus mitotane (17.1 month) than with streptozocin plus mitotane (4.7 months). Rates of serious adverse events did not differ significantly between treatments.CONCLUSIONS:Rates of response and progression-free survival were significantly better with EDP plus mitotane than with streptozocin plus mitotane as first-line therapy, with similar rates of toxic events, although there was no significant difference in overall survival.

Added entries (persons, corporate bodies, meetings, titles ...)

  • Terzolo, Massimo (author)
  • Allolio, Bruno (author)
  • Baudin, Eric (author)
  • Haak, Harm (author)
  • Berruti, Alfredo (author)
  • Welin, StaffanUppsala universitet,Institutionen för medicinska vetenskaper,Onkologisk endokrinologi(Swepub:uu)stafweli (author)
  • Schade-Brittinger, Carmen (author)
  • Lacroix, André (author)
  • Jarzab, Barbara (author)
  • Sorbye, Halfdan (author)
  • Torpy, David J (author)
  • Stepan, Vinzenz (author)
  • Schteingart, David E (author)
  • Arlt, Wiebke (author)
  • Kroiss, Matthias (author)
  • Leboulleux, Sophie (author)
  • Sperone, Paola (author)
  • Sundin, AndersKarolinska Institutet,Uppsala universitet,Enheten för radiologi(Swepub:uu)anderssu (author)
  • Hermsen, Ilse (author)
  • Hahner, Stefanie (author)
  • Willenberg, Holger S (author)
  • Tabarin, Antoine (author)
  • Quinkler, Marcus (author)
  • de la Fouchardière, Christelle (author)
  • Schlumberger, Martin (author)
  • Mantero, Franco (author)
  • Weismann, Dirk (author)
  • Beuschlein, Felix (author)
  • Gelderblom, Hans (author)
  • Wilmink, Hanneke (author)
  • Sender, Monica (author)
  • Edgerly, Maureen (author)
  • Kenn, Werner (author)
  • Fojo, Tito (author)
  • Müller, Hans-Helge (author)
  • Skogseid, BrittUppsala universitet,Institutionen för medicinska vetenskaper,Endokrin tumörbiologi(Swepub:uu)brittsko (author)
  • Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Related titles

  • In:New England Journal of Medicine366:23, s. 2189-21970028-47931533-4406

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