Endocrine Abstracts

Patients with Addison’s or adrenal insufficiency require regular steroid replacement usually in the form of oral hydrocortisone. Standard advice is given on how to deal with intercurrent illness and special situations such as surgery. Organisations such as the Addison’s disease self-help group provide authoritative guidelines for patients. Several of our patients with adrenal insufficiency have asked how their steroid replacement treatment should be adjusted for expe...

Background: Mitotane is an adrenolytic chemotherapy, currently accepted as first line adjuvant therapy in adrenocortical carcinoma. Mitotane has a narrow therapeutic window. Serum levels of >14 mg/l are required to achieve a cytotoxic effect and levels of >20 mg/l are potentially toxic. There are two strategies for mitotane initiation: a low-dose regimen (3 g) and a high-dose regimen (increase to 6g/day over 4 days and reduce to 4.5 g/day after 10 days).<p class="...

Introduction: Multi-modal therapy for adrenocortical carcinoma (ACC) includes surgery, therapy with the adrenolytic agent mitotane and systemic chemotherapy. Achievement of therapeutic mitotane concentrations (≥14 mg/l) has been related to improved outcomes.Aim: To evaluate the effectiveness of a defined* high dose protocol mitotane therapy in patients with advanced ACC (stages III and IV).Methods: Review of patients presenti...