Current Clinical Trials

Standard treatment options:

• Complete surgical removal of the tumor, with or without regional lymph node dissection is the treatment of choice for patients with stage III adrenocortical carcinomas. The treatment of patients who have tumors with local invasion, but without clinically enlarged regional lymph nodes, is complete surgical removal as for stage I and stage II tumors. For those with enlarged regional lymph nodes, a lymph node dissection should be included in the procedure. These patients are at a high risk for disease recurrence and should be considered for enrollment in a clinical trial.

Treatment options under clinical evaluation:

1. Clinical trials are appropriate for newly diagnosed patients when possible.
2. Radiation therapy: 4,200 rads to 5,000 rads given for a period of 4 weeks to patients with localized but unresectable tumors.[1]
3. For patients unable to undergo complete resection, mitotane in doses as high as 10 to 12 grams per day can be considered. This antitumor drug produces useful clinical responses that average 10 months in duration in about 30% of patients with measurable metastases. Responses in patients who achieve complete remission can be durable. Approximately 80% of treated patients with functioning tumors will show substantial diminution in hormone production. The drug is not usually used unless either radiologically evaluable metastases are present or the residual tumor is producing measurable levels of hormone.[2,3] Currently, no apparent role exists for mitotane as adjuvant therapy if the patient has undergone complete resection of the tumor.[3,4]

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III adrenocortical carcinoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References

1. Percarpio B, Knowlton AH: Radiation therapy of adrenal cortical carcinoma. Acta Radiol Ther Phys Biol 15 (4): 288-92, 1976.  [PUBMED Abstract]
   
   
2. Lubitz JA, Freeman L, Okun R: Mitotane use in inoperable adrenal cortical carcinoma. JAMA 223 (10): 1109-12, 1973.  [PUBMED Abstract]
   
   
3. Luton JP, Cerdas S, Billaud L, et al.: Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med 322 (17): 1195-201, 1990.  [PUBMED Abstract]
   
   
4. Vassilopoulou-Sellin R, Guinee VF, Klein MJ, et al.: Impact of adjuvant mitotane on the clinical course of patients with adrenocortical cancer. Cancer 71 (10): 3119-23, 1993.  [PUBMED Abstract]
   
   

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