OBJECTIVE: Temozolomide has shown a significant anti-proliferative activity on adrenocortical cancer (ACC) cells in vitro. DESIGN: On the basis of these results the drug was prescribed as second/third line in advanced metastatic ACC patients in 4 referral centers in Italy. METHODS: We retrospectively collected anagraphic, clinical and pathological data of patients with advanced ACC with disease progression to standard chemotherapy plus mitotane who were treated with temozolomide at the dose of 200 mg/m2/die given for 5 consecutive days every 28 days. The primary end-point was the disease control rate, defined as objective response or disease stabilization after 3 months. Secondary endpoints were overall survival (OS), progression free survival (PFS) and drug safety. RESULTS: Twenty-eight patients have been included in the study. Ten patients (35.8%, 95% CI 17.8-53.8) obtained a disease control from temozolomide treatment. In particular, 1 patient had a complete response, 5 patients a partial response and 4 patients stable disease. Median PFS was 3.5 months and median OS 7.2 months. Disease response was more frequently observed in patients with methylation of O6-methylguanine-DNA methyltransferase (MGMT) gene. Temozolomide therapy was well tolerated and most toxicities were limited to grade G1-2 according to WHO criteria. CONCLUSION: Temozolomide was found active in the management of advanced ACC patients. The disease control rate obtained, however, was short lived and the prognosis of treated patients was poor.

Activity and safety of temozolomide in advanced adrenocortical carcinoma patients

Cosentini, Deborah;Grisanti, Salvatore;Laganà, Marta;Ferrari, Vittorio;Sigala, Sandra;Berruti, Alfredo
2019-01-01

Abstract

OBJECTIVE: Temozolomide has shown a significant anti-proliferative activity on adrenocortical cancer (ACC) cells in vitro. DESIGN: On the basis of these results the drug was prescribed as second/third line in advanced metastatic ACC patients in 4 referral centers in Italy. METHODS: We retrospectively collected anagraphic, clinical and pathological data of patients with advanced ACC with disease progression to standard chemotherapy plus mitotane who were treated with temozolomide at the dose of 200 mg/m2/die given for 5 consecutive days every 28 days. The primary end-point was the disease control rate, defined as objective response or disease stabilization after 3 months. Secondary endpoints were overall survival (OS), progression free survival (PFS) and drug safety. RESULTS: Twenty-eight patients have been included in the study. Ten patients (35.8%, 95% CI 17.8-53.8) obtained a disease control from temozolomide treatment. In particular, 1 patient had a complete response, 5 patients a partial response and 4 patients stable disease. Median PFS was 3.5 months and median OS 7.2 months. Disease response was more frequently observed in patients with methylation of O6-methylguanine-DNA methyltransferase (MGMT) gene. Temozolomide therapy was well tolerated and most toxicities were limited to grade G1-2 according to WHO criteria. CONCLUSION: Temozolomide was found active in the management of advanced ACC patients. The disease control rate obtained, however, was short lived and the prognosis of treated patients was poor.
File in questo prodotto:
File Dimensione Formato  
2019 Dec - Activity and safety of temozolomide in advanced adrenocortical carcinoma patients.pdf

solo utenti autorizzati

Tipologia: Full Text
Licenza: DRM non definito
Dimensione 552.28 kB
Formato Adobe PDF
552.28 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/527656
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 15
  • Scopus 27
  • ???jsp.display-item.citation.isi??? 27
social impact