o,p′‐DDD (mitotane) therapy of adrenal cortical carcinoma. Observations on drug dosage, toxicity, and steroid replacement

Abstract

Four patients with adrenal cortical carcinoma were treated with standard doses of o,p′‐DDD. Plasma levels of o,p′‐DDD and its metabolites o,p′‐DDA and o,p′‐DDE were measured. o,p′‐DDD was measurable for up to 8 months after stopping therapy, and trace levels of metabolites were detectable at 18 months. Although 2 of 3 patients with measurable disease had objective tumor response and one patient achieved a complete response, severe drug toxicity occurred in all patients and signs of adrenal insufficiency occurred in three. Low dose therapy with o,p′‐DDD is suggested, together with full gluco and mineralo‐corticoid replacement. Measurement of o,p′‐DDD and its metabolites in plasma may prove clinically useful in developing effective but less toxic dosage schedules. Cancer 42:2177–2181, 1978. Copyright © 1978 American Cancer Society