Medical Approaches in Adrenocortical Carcinoma
Adrenocortical carcinoma (ACC) represents one of the most aggressive endocrine tumors. In spite of a correct therapeutic strategy based on a multidisciplinary approach between endocrinologist, surgeon and oncologist, the prognosis is often poor. Surgery is the mainstay treatment in ACC. Mitotane, a...
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MDPI AG
2020-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/8/12/551 |
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| author | Rosa Maria Paragliola Andrea Corsello Pietro Locantore Giampaolo Papi Alfredo Pontecorvi Salvatore Maria Corsello |
| author_facet | Rosa Maria Paragliola Andrea Corsello Pietro Locantore Giampaolo Papi Alfredo Pontecorvi Salvatore Maria Corsello |
| author_sort | Rosa Maria Paragliola |
| collection | DOAJ |
| description | Adrenocortical carcinoma (ACC) represents one of the most aggressive endocrine tumors. In spite of a correct therapeutic strategy based on a multidisciplinary approach between endocrinologist, surgeon and oncologist, the prognosis is often poor. Surgery is the mainstay treatment in ACC. Mitotane, a dichloro-diphenyl-trichloro-ethane derivate, represents the main medical treatment of ACC in consideration of its adrenocytolitic activity and it is mainly employed as adjuvant treatment after complete surgical resection and for the treatment of advanced ACC. However, the use of mitotane as adjuvant therapy is still controversial, also in consideration of the retrospective nature of several studies. The recurrence of disease is frequent, especially in advanced disease at the diagnosis. Therefore, in these contexts, conventional chemotherapy must be considered in association with mitotane, being the combination etoposide, doxorubicin and cisplatin (EDP) the standard of care in this setting. A more modern therapeutic approach, based on the need of a salvage therapy for advanced ACC that progresses through first-line EDP, is focused on molecular-targeted therapies. However, robust clinical trials are necessary to assess the real efficacy of these treatments. |
| first_indexed | 2024-03-10T14:27:28Z |
| format | Article |
| id | doaj.art-bbab1b35e16d4b22a4a05433c121734b |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T14:27:28Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-bbab1b35e16d4b22a4a05433c121734b2023-11-20T22:53:58ZengMDPI AGBiomedicines2227-90592020-11-0181255110.3390/biomedicines8120551Medical Approaches in Adrenocortical CarcinomaRosa Maria Paragliola0Andrea Corsello1Pietro Locantore2Giampaolo Papi3Alfredo Pontecorvi4Salvatore Maria Corsello5Department of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyDepartment of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyDepartment of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyDepartment of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyDepartment of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyDepartment of Translational Medicine and Surgery, Unit of Endocrinology, Università Cattolica del Sacro Cuore—Fondazione Policlinico “Gemelli” IRCCS, Largo Gemelli 8, 00168 Rome, ItalyAdrenocortical carcinoma (ACC) represents one of the most aggressive endocrine tumors. In spite of a correct therapeutic strategy based on a multidisciplinary approach between endocrinologist, surgeon and oncologist, the prognosis is often poor. Surgery is the mainstay treatment in ACC. Mitotane, a dichloro-diphenyl-trichloro-ethane derivate, represents the main medical treatment of ACC in consideration of its adrenocytolitic activity and it is mainly employed as adjuvant treatment after complete surgical resection and for the treatment of advanced ACC. However, the use of mitotane as adjuvant therapy is still controversial, also in consideration of the retrospective nature of several studies. The recurrence of disease is frequent, especially in advanced disease at the diagnosis. Therefore, in these contexts, conventional chemotherapy must be considered in association with mitotane, being the combination etoposide, doxorubicin and cisplatin (EDP) the standard of care in this setting. A more modern therapeutic approach, based on the need of a salvage therapy for advanced ACC that progresses through first-line EDP, is focused on molecular-targeted therapies. However, robust clinical trials are necessary to assess the real efficacy of these treatments.https://www.mdpi.com/2227-9059/8/12/551adrenocortical carcinomamitotaneetoposidecisplatindoxorubicinimmune checkpoint inhibitors |
| spellingShingle | Rosa Maria Paragliola Andrea Corsello Pietro Locantore Giampaolo Papi Alfredo Pontecorvi Salvatore Maria Corsello Medical Approaches in Adrenocortical Carcinoma Biomedicines adrenocortical carcinoma mitotane etoposide cisplatin doxorubicin immune checkpoint inhibitors |
| title | Medical Approaches in Adrenocortical Carcinoma |
| title_full | Medical Approaches in Adrenocortical Carcinoma |
| title_fullStr | Medical Approaches in Adrenocortical Carcinoma |
| title_full_unstemmed | Medical Approaches in Adrenocortical Carcinoma |
| title_short | Medical Approaches in Adrenocortical Carcinoma |
| title_sort | medical approaches in adrenocortical carcinoma |
| topic | adrenocortical carcinoma mitotane etoposide cisplatin doxorubicin immune checkpoint inhibitors |
| url | https://www.mdpi.com/2227-9059/8/12/551 |
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