Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma
(1) Background: In clinical settings, data regarding sex are rarely investigated. In women, factors such as body size and composition, hormonal variations, metabolism, and access to care systems and therapy could strongly influence the pharmacological management and the outcome of the therapy. To un...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-03-01
|
Series: | Life |
Subjects: | |
Online Access: | https://www.mdpi.com/2075-1729/11/3/266 |
_version_ | 1797540268058083328 |
---|---|
author | Sarah Allegra Soraya Puglisi Irene Brescia Francesco Chiara Vittoria Basile Anna Calabrese Giuseppe Reimondo Silvia De Francia |
author_facet | Sarah Allegra Soraya Puglisi Irene Brescia Francesco Chiara Vittoria Basile Anna Calabrese Giuseppe Reimondo Silvia De Francia |
author_sort | Sarah Allegra |
collection | DOAJ |
description | (1) Background: In clinical settings, data regarding sex are rarely investigated. In women, factors such as body size and composition, hormonal variations, metabolism, and access to care systems and therapy could strongly influence the pharmacological management and the outcome of the therapy. To underline this sex-related difference, we retrospectively collected data from adrenocortical carcinoma patients treated with mitotane, and then evaluated sex-related pharmacokinetics parameters. (2) Methods: A fully validated chromatographic method was used to quantify mitotane concentration in plasma collected from adult patients, also considering the active metabolite ortho,para,dichlorodiphenylethene (o,p′-DDE). Statistical analyses were used to evaluate the sex influence on drugs pharmacokinetics. (3) Results: We found that sex resulted as predictive factor of plasma mitotane and o,p′-DDE concentrations and significantly influenced the attainment of the therapeutic target of mitotane, implying that female sex could be a risk factor of treatment failure. (4) Conclusions: These results suggest that mitotane therapy should be modulated according to patient sex. Furthermore, the proposed approach could contribute to facilitating and disseminating sex-specific pharmacology. |
first_indexed | 2024-03-10T12:57:41Z |
format | Article |
id | doaj.art-06e0a2cccf144be8bc4647afccf86e7d |
institution | Directory Open Access Journal |
issn | 2075-1729 |
language | English |
last_indexed | 2024-03-10T12:57:41Z |
publishDate | 2021-03-01 |
publisher | MDPI AG |
record_format | Article |
series | Life |
spelling | doaj.art-06e0a2cccf144be8bc4647afccf86e7d2023-11-21T11:42:41ZengMDPI AGLife2075-17292021-03-0111326610.3390/life11030266Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical CarcinomaSarah Allegra0Soraya Puglisi1Irene Brescia2Francesco Chiara3Vittoria Basile4Anna Calabrese5Giuseppe Reimondo6Silvia De Francia7Laboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyLaboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyLaboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, ItalyLaboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, TO, Italy(1) Background: In clinical settings, data regarding sex are rarely investigated. In women, factors such as body size and composition, hormonal variations, metabolism, and access to care systems and therapy could strongly influence the pharmacological management and the outcome of the therapy. To underline this sex-related difference, we retrospectively collected data from adrenocortical carcinoma patients treated with mitotane, and then evaluated sex-related pharmacokinetics parameters. (2) Methods: A fully validated chromatographic method was used to quantify mitotane concentration in plasma collected from adult patients, also considering the active metabolite ortho,para,dichlorodiphenylethene (o,p′-DDE). Statistical analyses were used to evaluate the sex influence on drugs pharmacokinetics. (3) Results: We found that sex resulted as predictive factor of plasma mitotane and o,p′-DDE concentrations and significantly influenced the attainment of the therapeutic target of mitotane, implying that female sex could be a risk factor of treatment failure. (4) Conclusions: These results suggest that mitotane therapy should be modulated according to patient sex. Furthermore, the proposed approach could contribute to facilitating and disseminating sex-specific pharmacology.https://www.mdpi.com/2075-1729/11/3/266AACo,p′-DDDo,p′-DDETDMgender |
spellingShingle | Sarah Allegra Soraya Puglisi Irene Brescia Francesco Chiara Vittoria Basile Anna Calabrese Giuseppe Reimondo Silvia De Francia Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma Life AAC o,p′-DDD o,p′-DDE TDM gender |
title | Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma |
title_full | Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma |
title_fullStr | Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma |
title_full_unstemmed | Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma |
title_short | Sex Differences on Mitotane Concentration and Treatment Outcome in Patients with Adrenocortical Carcinoma |
title_sort | sex differences on mitotane concentration and treatment outcome in patients with adrenocortical carcinoma |
topic | AAC o,p′-DDD o,p′-DDE TDM gender |
url | https://www.mdpi.com/2075-1729/11/3/266 |
work_keys_str_mv | AT sarahallegra sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT sorayapuglisi sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT irenebrescia sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT francescochiara sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT vittoriabasile sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT annacalabrese sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT giuseppereimondo sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma AT silviadefrancia sexdifferencesonmitotaneconcentrationandtreatmentoutcomeinpatientswithadrenocorticalcarcinoma |