After the complete tumor resection, not all patients with an adrenocortical carcinoma require the previous standard therapy Mitotane. Professors Martin Fassnacht and Massimo Terzolo show this in a clinical trial.
In 2017, the teams of Massimo Terzolo and Martin Fassnacht published a study in the New England Journal of Medicine that provided evidence for the efficacy of Mitotane in the prevention of recurrence in adrenocortical carcinoma. This study established the drug worldwide as a standard therapy for relapse prophylaxis after surgical removal of the tumor, regardless of risk factors that were still unknown at the time.
Professor Martin Fassnacht, Chair of the Department of Endocrinology and Diabetology at Würzburg University Hospital No improvement with low risk of recurrence ADIUVO is the first-ever randomized trial worldwide of adjuvant treatment for adrenocortical carcinoma. A total of 91 patients in 23 centers in seven countries were randomized to either receive oral Mitotane for two years or to be monitored "only" by imaging and laboratory controls after surgical removal of their adrenocortical carcinoma and low to intermediate risk of recurrence .
A first step towards personalized medicine in this rare disease Martin Fassnacht sums up: "Concomitant therapy with Mitotane is not indicated in patients with low-grade, localized adrenocortical carcinoma in which the tumor has not yet metastasized and could be completely removed, as their prognoses are relatively good and treatment with Mitotane does not show a statistically significant improvement in the relapse rate, but is associated with side effects.
The usually highly malignant tumor of this endocrine gland, which sit in pairs on the kidneys, has been the focus of Würzburg endocrinology for more than 20 years. The European Adrenal Tumour Network ENSAT and the German Adrenal Carcinoma Study Group are coordinated from here.
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Study shows no mitotane needed for patients with low risk of recurrence of adrenocortical carcinomaIn 2007, the teams of Massimo Terzolo and Martin Fassnacht published a study in the New England Journal of Medicine that provided evidence for the efficacy of mitotane in the prevention of recurrence in adrenocortical carcinoma. This study established the drug worldwide as a standard therapy for relapse prophylaxis after surgical removal of the tumor, regardless of risk factors that were still unknown at the time.
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