Evidence map›Paper›PMID 41503252›Full record

ArticleEndocrine oncology (Bristol, England)2026

Mitotane dosage, plasma levels, and anthropometric measurements in pediatric adrenocortical carcinoma.

Maria Riedmeier, Heidi Frey, Sonir R Antonini, Gabriela Fernandes Luiz Canali, Carl Friedrich Classen, Nerea Domínguez-Pinilla, Martin Fassnacht, Jasmin Finger, Steffen Fuchs, Marika Grönroos and 19 more

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Article in Endocrine oncology (Bristol, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Maria RiedmeierUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.ORCID https://orcid.org/0000-0002-3273-1794
Heidi FreyUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.
Sonir R AntoniniDepartment of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil.ORCID https://orcid.org/0000-0003-4778-8803
Gabriela Fernandes Luiz CanaliOncologia, Pequeno Principe Hospital, Curitiba, Paraná, Brazil.
Carl Friedrich ClassenDivision of Pediatric Oncology, Hematology and Palliative Medicine Section, Department of Pediatrics and Adolescent Medicine, University Medicine Rostock, Rostock, Germany.
Nerea Domínguez-PinillaPediatric Hematology and Oncology Unit, University Hospital 12 de Octubre, i+12 Research Institute, Madrid, Spain.
Martin FassnachtDepartment of Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany.
Jasmin FingerPediatric Hematology, Oncology and BMT, University Hospital Münster, Münster, Germany.
Steffen FuchsDepartment of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Marika GrönroosDepartment of Pediatrics, Turku University Hospital, Turku, Finland.
Mariana P HalahDepartment of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil.
Christoph HärtelUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.
Dominika JanusDepartment of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, University Children Hospital, Krakow, Poland.
Antoinette Jaspers-BakkerPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Ronald R de KrijgerPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Tezer KutlukDepartment of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Mouna MezouedDepartment of Endocrinology and Metabolism Bologhine Hospital, Algiers, Algeria.
Jessica MunarinDepartment of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy.
Max van NoeselPrincess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Nihal Özdemir KöseUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.
Simon H PearceDepartment of Endocrinology, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Thomas PerweinDivision of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Soraya PuglisiInternal Medicine, Department of Clinical and Biological Sciences, S Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Paul-Gerhardt SchlegelUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.
Vera Binder-BlaserDepartment of Pediatric Oncology and Hematology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Gerdi TuliDepartment of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy.
Justyna WalenciakDepartment of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland.
Bilgehan YalcinDepartment of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Verena WiegeringUniversity Hospital Würzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany.ORCID https://orcid.org/0000-0002-2802-4034

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Mitotane is an effective treatment for advanced adrenocortical carcinoma (ACC). Given the limited pediatric data available, this study aims to evaluate the associations between mitotane dosage, plasma drug levels, and anthropometric measurements, as well as their potential impact on dosage requirements to optimize therapeutic outcomes in pediatric patients with ACC (pACC). Design and methods: A retrospective, international, multicenter study was conducted on pediatric ACC patients treated with mitotane across 18 centers. Mitotane serum levels were obtained from the Lysosafe Online® database or directly from the centers. Data from the cohort with plasma levels within the target range (≥14 mg/L; Results: Fifty pediatric patients (60% female) diagnosed between 2004 and 2023 were included, with a median follow-up of 34.5 months and a 10-year overall survival of 33 months. The median age at diagnosis was 8.6 years, with most tumors (84%) hormone-secreting. Among 49 patients undergoing surgery, 31 (62%) achieved R0 resection. The median treatment duration was 18 months, with a median mitotane dose of 87 mg/kg/day in patients within the target plasma level range, showing no significant difference from those outside the range. However, BMI was significantly associated with doses of plasma levels in target range ( Conclusion: This study supports estimating mitotane dosages in pediatric ACC, emphasizing the need for close monitoring and frequent follow-ups at specialized centers due to individualized dosing and a narrow therapeutic window.

Indexed as

mitotanemitotane dosagemitotane plasma levelpediatric adrenocortical carcinomapediatric adrenocortical tumor

Identifiers

PMID41503252
PMCPMC12771559

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