Endocrine Abstracts

Bone loss is a frequent complication of aromatase inhibitors (AIs) therapy in women with breast cancer. Bone-active drugs are effective in protecting the skeleton from detrimental actions of AIs. However, bone mineral density (BMD) was the primary end-point in most of published studies, whereas data on fractures were scant and mainly limited to denosumab. In this prospective study, we investigated the effects of denosumab, oral bisphosphonates and intravenous zoledronate on ri...

Background: Adrenocortical carcinoma (ACC) is a rare cancer associated with hereditary syndromes in 10% of cases. However, data on germline variants (GVs) in adult patients with sporadic ACC are limited.Methods: We analyzed germline DNA from 150 adult patients with sporadic ACC sequentially referred to our centers between 1998-2019. We designed a custom panel of 17 genes potentially involved in the pathogenesis of ACC: AIP, APC, ARMC5, ARNT, BRCA1, BRCA2...

Background: Adrenocortical carcinoma (ACC) is a rare cancer for which available systemic treatments, mitotane ± etoposide, doxorubicin and cisplatin (EDP-M), have limited efficacy.Objectives: Here, we strengthen the effect of progesterone (Pg) on metastatic ACC cell lines, studying whether it could influence growth, invasiveness, and metastasis formation. Additionally, we investigate if the Pg analogue megestrol-acetate administered with EDP-M could...

Background: More than 50% of adrenocortical carcinomas (ACC) in adults are associated with cortisol excess that makes tumor management challenging and has a negative impact on patient outcome. Abiraterone acetate (AA) is an irreversible inhibitor of the 17α-hydroxylase/C17, 20-lyase (CYP17 enzyme) that is used in patients with prostate cancer, in whom it leads to suppression of cortisol and androgens. The aim of this study was to assess the activity of AA to control corti...

Background: Skeletal fragility is an important clinical issue in women with early-stage breast cancer and men with non-metastatic prostate cancer under hormonal hormone deprivation therapies (HDTs). Vertebral fractures (VFs) have been reported in a remarkable number of subjects exposed to HDT especially when the diagnosis of fractures is performed by a radiological and morphometric approach. Notably, prediction of fractures in this clinical setting is a challenge and determina...

Introduction: Bone mineral density (BMD) is considered a valid surrogate of bone strength in postmenopausal women, however it lacks sensitivity in individual fracture risk assessment in the setting of women with early breast cancer (EBC) patients treated with aromatase inhibitors (AIs). Indeed, mechanical resistance of bone only partially depends on bone quantity, and bone geometry and size play an important role in bone resistance to fractures. In this cross-sectional study, ...

Background: The management of adjuvant mitotane therapy in patients with adrenocortical carcinoma (ACC) is challenging. Plasma mitotane concentrations>14 mg/l have been associated with efficacy in the treatment of advanced ACC; however, data in the adjuvant setting are mixed. Moreover, there is no consensus on how to assess the optimal exposure to mitotane and all the proposed methods have inherent limitations. We have recently proposed a new method analogous to what is es...

Background: Adrenocortical carcinoma (ACC) has an aggressive but heterogenous behaviour. ENSAT stage and Ki67 proliferation index are used to predict clinical outcome but are limited in distinguishing patients with best outcome. We aimed to validate the prognostic role of clinical and histopathological parameters alone or combined by applying a previously proposed points-based score (mGRAS, Lippert JCEM 2018) to a large multicentre cohort of ACC patients.<p class="abstext"...