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  • Author: Jean-Paul Travagli x
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Pasqualino Malandrino
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Abir Al Ghuzlan Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Marine Castaing Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Jacques Young Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Bernard Caillou Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Jean-Paul Travagli Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Dominique Elias Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Thierry de Baere Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Clarisse Dromain Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Angelo Paci Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Philippe Chanson Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Département d'Anatomo-Pathologie, G.F. Ingrassia Department, Service d'Endocrinologie, Département de Chirurgie, Département d'Imagerie, Département de Pharmacologie Clinique, Institut Gustave-Roussy, Université Paris XI, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France

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Martin Schlumberger
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Sophie Leboulleux
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Eric Baudin
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To progress in the stratification of the first-line therapeutic management of metastatic adrenocortical carcinoma (ACC), we searched for prognostic parameters of survival in patients treated with combined mitotane- and cisplatinum-based chemotherapy as first-line. We retrospectively studied prospectively collected parameters from 131 consecutive patients with metastatic ACC (44 with a tissue specimen available) treated at the Gustave Roussy Institute with mitotane- and platinum-based chemotherapy. Fifty-five patients with clinical, pathological, and morphological data available together with treatment characteristics including detailed follow-up were enrolled. Plasma mitotane levels and ERCC1 protein staining were analyzed. Response was analyzed according to RECIST criteria as well as overall survival (OS) from the start of cisplatinum-based chemotherapy. Parameters impacting on OS were evaluated by univariate analysis, and then analyzed by multivariate analysis. Using a landmark method, OS according to response to chemotherapy was analyzed. Objective response to combined mitotane- and cisplatinum-based chemotherapy was 27.3%. Median OS was 1 year. In the univariate analysis, resection of the primary, time since diagnosis, mitotane monotherapy as single first-line treatment, number of affected organs, plasma mitotane above 14 mg/l, and objective response were predictors of survival. In the multivariate analysis, mitotane level ≥14 mg/l and objective response to platinum-based chemotherapy were found to be independent predictors of survival (P=0.03 and <0.001). Our study suggests a prognostic role for mitotane therapy and objective response to platinum-based chemotherapy.

Article Type:
Research Article
DOI:
https://doi.org/10.1677/ERC-09-0341
Volume/Issue:
Volume 17: Issue 3
Free access