Prognostic markers of survival after combined mitotane- and platinum-based chemotherapy in metastatic adrenocortical carcinoma

Details

Serval ID
serval:BIB_E8C8220C48FB
Type
Article: article from journal or magazin.
Collection
Publications
Title
Prognostic markers of survival after combined mitotane- and platinum-based chemotherapy in metastatic adrenocortical carcinoma
Journal
Endocr Relat Cancer
Author(s)
Malandrino P., Al Ghuzlan A., Castaing M., Young J., Caillou B., Travagli J. P., Elias D., de Baere T., Dromain C., Paci A., Chanson P., Schlumberger M., Leboulleux S., Baudin E.
ISSN-L
1479-6821 (Electronic)1351-0088 (Linking)
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
17
Number
3
Pages
797-807
Language
english
Notes
Malandrino, PasqualinoAl Ghuzlan, AbirCastaing, MarineYoung, JacquesCaillou, BernardTravagli, Jean-PaulElias, Dominiquede Baere, ThierryDromain, ClarissePaci, AngeloChanson, PhilippeSchlumberger, MartinLeboulleux, SophieBaudin, EricengEngland2010/07/02 06:00Endocr Relat Cancer. 2010 Aug 16;17(3):797-807. doi: 10.1677/ERC-09-0341. Print 2010 Sep.
Abstract
To progress in the stratification of the first-line therapeutic management of metastatic adrenocortical carcinoma (ACC), we searched for prognostic parameters of survival in patients treated with combined mitotane- and cisplatinum-based chemotherapy as first-line. We retrospectively studied prospectively collected parameters from 131 consecutive patients with metastatic ACC (44 with a tissue specimen available) treated at the Gustave Roussy Institute with mitotane- and platinum-based chemotherapy. Fifty-five patients with clinical, pathological, and morphological data available together with treatment characteristics including detailed follow-up were enrolled. Plasma mitotane levels and ERCC1 protein staining were analyzed. Response was analyzed according to RECIST criteria as well as overall survival (OS) from the start of cisplatinum-based chemotherapy. Parameters impacting on OS were evaluated by univariate analysis, and then analyzed by multivariate analysis. Using a landmark method, OS according to response to chemotherapy was analyzed. Objective response to combined mitotane- and cisplatinum-based chemotherapy was 27.3%. Median OS was 1 year. In the univariate analysis, resection of the primary, time since diagnosis, mitotane monotherapy as single first-line treatment, number of affected organs, plasma mitotane above 14 mg/l, and objective response were predictors of survival. In the multivariate analysis, mitotane level > or =14 mg/l and objective response to platinum-based chemotherapy were found to be independent predictors of survival (P=0.03 and <0.001). Our study suggests a prognostic role for mitotane therapy and objective response to platinum-based chemotherapy.
Keywords
Adrenal Cortex Neoplasms/*drug therapy/*metabolism/mortality, Adrenocortical Carcinoma/*drug therapy/*metabolism/mortality, Adult, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Biomarkers, Tumor/*metabolism, Cisplatin/administration & dosage, DNA-Binding Proteins/metabolism, Endonucleases/metabolism, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Mitotane/administration & dosage/blood, Prognosis, Prospective Studies, Retrospective Studies, Survival Rate, Treatment Outcome
Open Access
Yes
Create date
16/09/2016 11:13
Last modification date
20/08/2019 17:11
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