ArticleCancers2020
Unwanted Hormonal and Metabolic Effects of Postoperative Adjuvant Mitotane Treatment for Adrenocortical Cancer.
Article in Cancers, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and Safety of Radiotherapy and Systemic Treatments in Adrenocortical Carcinoma: Systematic Review and Meta-Analysis.The Journal of clinical endocrinology and metabolism · 2025Pooled it
- Thyroid function and ultrasound surveillance in childhood cancer survivors (CCS): a position paper of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED).Journal of endocrinological investigation · 2026Review
- Real-world safety profile of mitotane in adrenocortical carcinoma: a retrospective cross-sectional study integrating pharmacovigilance and interpretable machine learning.Frontiers in endocrinology · 2026Article
- Mitotane-Induced Hypothyroidism and Dyslipidemia in Adrenocortical Carcinoma: Sex Differences and Novel Evidence from a Thyroid Cell Model.Current oncology (Toronto, Ont.) · 2025Article
- Update on diagnostic and therapeutic challenges of central hypothyroidism among childhood cancer survivors.Journal of endocrinological investigation · 2025Review
- Mitotane-Induced Endocrine Alterations in Children with Adrenocortical Carcinoma: Clinical Implications from a 20-Year Retrospective Study.Children (Basel, Switzerland) · 2025Article
- A review of mitotane in the management of adrenocortical cancer.The oncologist · 2024Review
- Precocious puberty and other endocrine disorders during mitotane treatment for paediatric adrenocortical carcinoma - case series and literature review.Pediatric endocrinology, diabetes, and metabolism · 2024Review
- The effect of adjuvant mitotane therapy of the adrenocortical carcinoma on the endometrium and its clinical consequences in menstruating women. Literature review and authors' own experiences.American journal of cancer research · 2024Review
- Early Detection of Recurrence and Progress Using Serum Steroid Profiling by LC-MS/MS in Patients with Adrenocortical Carcinoma.Metabolites · 2023Article
- Effect of Mitotane on Male Gonadal Function.Cancers · 2023Article
- Review
- Neurological adverse events of mitotane in adrenocortical carcinoma: results of a pilot study.Frontiers in oncology · 2023Article
- Androgen serum levels in male patients with adrenocortical carcinoma given mitotane therapy: A single center retrospective longitudinal study.Frontiers in endocrinology · 2023Article
- Hypogonadism and sexual function in men affected by adrenocortical carcinoma under mitotane therapy.Frontiers in endocrinology · 2023Article
- Sex-Based Evaluation of Lipid Profile in Postoperative Adjuvant Mitotane Treatment for Adrenocortical Carcinoma.Biomedicines · 2022Article
- Review
- EDP-mitotane in children: reassuring evidence of reversible side-effects and neurotoxicity.Discover oncology · 2022Review
- Characterization of hyperlipidemia secondary to mitotane in adrenocortical carcinoma.Endocrine oncology (Bristol, England) · 2022Article
- Molecular Mechanisms of Mitotane Action in Adrenocortical Cancer Based on In Vitro Studies.Cancers · 2021Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Mitotane is widely used for the treatment of adrenocortical cancer (ACC), although the drug-related toxicity complicates its use. The aim of this study is to assess comprehensively the different endocrine and metabolic unwanted effects of the drug, and to provide data on the supportive therapies. We retrospectively analyzed 74 ACC patients adjuvantly treated with mitotane for ≥12 months. During the treatment period (40 months, 12-195), 32.4% of patients needed replacement therapy for mineralocorticoid deficit, 36.2% for hypothyroidism and 34.3% for male hypogonadism. In fertile women, hypogonadism was uncommon, while 65.4% of women developed ovarian cysts. Although no significant change in low-density lipoprotein (LDL) was observed, statins were started in 50% of patients for a significant increase in total cholesterol and triglycerides. Dyslipidemia occurred early, after a median time of 6 months from mitotane start. Conversely, testosterone replacement was usually started after >2 years. In many cases, ranging from 29.4% to 50% according to the side effect, toxicity occurred well before the achievement of the target mitotane concentrations. Supportive therapies were able to revert the biochemical alterations induced by mitotane, although higher doses were needed for a likely pharmacokinetic interaction of exogenous steroids and statins with mitotane. In conclusion, adjuvant mitotane therapy is associated with a spectrum of unwanted effects encompassing the function of different endocrine glands and requires a careful clinical and biochemical assessment associated with the therapeutic drug monitoring.
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