Efficiency of platinum-based chemotherapy re-induction for adrenocortical cancer treatment

Zhulikov Ya., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Kovalenko E., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Bokhian V., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO) ; Pirogov Russian National Research Medical University

Evdokimova E., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Khoroshilov M., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Gabrava M., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Kolobanova E., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO)

Artamonova E., Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO) ; Pirogov Russian National Research Medical University

Abstract
The combination of platinum-based chemotherapy with mitotane (m) is the standard first-line therapy for metastatic adrenocortical cancer (ACC) with long-term disease control in approximately 25% of patients. Considering the lack of effective regimens for second and subsequent lines of therapy, it seems relevant to evaluate the effectiveness of platinum-based chemotherapy re-induction for patients with long platinum-free interval. Aim:Evaluation of the platinum-based chemotherapy re-induction efficiency with or without mitotane for patients with metastatic ACC.Materials and methods:This retrospective clinical study included patients with disease progression ≥ 6 months after completion of platinum-based chemotherapy for metastatic ACC. Results:17 patients were included, of which 16 received EDP+/-m regimen and 1 - EP. The median platinum-free interval was 8.3 months (7.2-39.7). Concurrent mitotane therapy was administered in 14 patients (82.35%), all of them achieved therapeutic concentration. Objective response and disease control ≥6 months rate were observed in 23.52% (N=4) and 52.94% (N=9), respectively. The median progression-free survival was 6.17 months, and the median overall survival 15.63 months.Conclusion:This study demonstrated the efficacy of platinum-based chemotherapy re-induction in metastatic ACC. The selected group of patients in our study with relatively platinum-sensitive disease does not allow to perform cross trial comparisons. Based on the results described above, we recommend considering re-induction of platinum-based chemotherapy with mitotane for patients with a platinum-free interval of ≥6 months as an option of second or further lines of treatment.

Keywords
adrenocortical cancer, re-induction, platinum-based chemotherapy, EDP, mitotane

Cite this paper
Zhulikov Ya., Kovalenko E., Bokhian V., Evdokimova E., Khoroshilov M., Gabrava M., Kolobanova E., Artamonova E., Efficiency of platinum-based chemotherapy re-induction for adrenocortical cancer treatment , SCIREA Journal of Clinical Medicine. Volume 7, Issue 5, October 2022 | PP. 302-311. 10.54647/cm32932

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