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The first randomised trial in advanced adrenocortical carcinoma showed that etoposide, doxorubicin and cisplatin with mitotane shrank tumours more often and held them back longer than streptozocin with mitotane, making EDP-mitotane the standard.
International randomised phase 3 trial of 304 patients with advanced adrenocortical carcinoma assigned to etoposide, doxorubicin and cisplatin plus mitotane (EDP-M) or streptozocin plus mitotane, with crossover at progression.
Response rates were 23.2 percent with EDP-M against 9.2 percent, and median progression-free survival 5.0 against 2.1 months; median overall survival was 14.8 against 12.0 months, not statistically different, partly because of crossover. Serious adverse events were similar.
EDP-mitotane is the first-line chemotherapy for adrenocortical carcinoma that cannot be removed, and the comparator arm for new trials; outcomes remain poor and better drugs are needed.
Shares Mitotane, Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
Shares Mitotane, Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
Shares Etoposide, New England Journal of Medicine, Cisplatin.