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After complete removal of a low-grade adrenal cancer, two years of mitotane did not significantly reduce recurrence or improve survival compared with surveillance, and every patient on it had side effects.
International multicentre open-label randomised phase 3 trial with a parallel observational study: 91 patients with completely resected low- to intermediate-risk adrenocortical carcinoma were randomised to adjuvant mitotane (45) or surveillance (46) between 2008 and 2018, when the trial closed for slow recruitment.
Five-year recurrence-free survival was 79 percent with mitotane against 75 percent with surveillance (hazard ratio 0.74, 95% CI 0.30 to 1.85); five-year overall survival 95 against 86 percent with two and five deaths. All 42 treated patients had adverse events and 19 percent discontinued.
Adjuvant mitotane may be withheld in low-grade localised adrenocortical carcinoma, given the good prognosis and the drug's toxicity.
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Adrenocortical carcinoma.
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Adrenocortical carcinoma.