Endocrine Abstracts

Purpose: Mitotane is the reference systemic therapy for adrenocortical carcinoma (ACC), but its mechanism of action and possible predictors of treatment response remain poorly defined. Our aim was to evaluate the gene expression of ribonucleotide reductase large subunit 1 (RRM1) and excision repair cross-complementation group 1 (ERCC1) in ACC as potential biomarkers for clinical outcome and response to mitotane.Experimental design: Forty-five and 47 tiss...

Adrenocortical carcinoma (ACC) is a rare malignancy and most of the therapeutic strategies are not yet prospectively validated. However, several studies have been published in 2010 and preliminary results from two prospective trials are available now.Open adrenalectomy is treatment of choice for resectable tumors. However, two recent retrospective studies provided evidence that a laparoscopic approach might be also a safe alternative in selected cases (e...

Adrenocortical carcinoma (ACC) is a very severe endocrine malignancy with poor prognosis. While cancer immunotherapies have revolutionized the treatment of several cancer entities, the results of initial studies of different immune checkpoint inhibitors in ACC were heterogeneous and clinically substantial responses were observed only in a subset of patients. Expression of immune checkpoint molecules - programmed cell death 1 (PD-1), its ligand PD-L1 and cytotoxic T Lymphocytes...

Introduction: The genetic mechanisms underlying adrenocortical tumor development are still largely unknown. We used high-resolution single nucleotide polymorphism (SNP) microarrays to detect copy number alterations (CNAs) and copy neutral losses of heterozygosity (cnLOH) in cortisol-secreting adrenocortical adenomas (ACAs). We focused on microalterations aiming to discover new candidate genes involved in early tumorigenesis and/or autonomous cortisol secretion.<p class="ab...

In recent years, it was demonstrated that tumor infiltrating and circulating regulatory and cytotoxic T-cells are associated with clinical outcome in several solid tumors. However, their role in adrenocortical carcinoma (ACC) was never studied, although 60% of these tumors secrete autonomously cortisol, a well-established potent immunosuppressant that most likely influences the balance between different T-cells.Firstly, we analyzed the circulating regula...

Background: Adrenocortical carcinoma (ACC) is a rare solid tumor with poor prognosis in advanced stages. The adrenolytic drug mitotane and cytotoxic chemotherapies are current treatment options with limited clinical efficacy. Animal experiments pointed to an adrenotoxic effect of sunitinib suggesting potential antineoplastic activity in ACC.Study population: Thirty-eight patients with advanced ACC progressing after mitotane and 1–3 cytotoxic chemoth...

Objective: Local tumor recurrence is common in adrenocortical carcinoma (ACC) and the most frequent cause for re-operation. Therefore, a concept for an adjuvant treatment is urgently needed. The role of radiotherapy in ACC has not been well defined and many authors have considered radiotherapy as ineffective. However, two studies with a small number of patients (n=3 and n=4, resp.) have suggested adjuvant radiation as an effective treatment to prevent recurrence ...

A recent study has reported impaired subjective health status (SHS) in 79 patients with primary adrenal insufficiency (AI) despite routine steroid replacement1. Here we have performed a survey in a large cohort of patients with primary and secondary AI. 348 patients (148 outpatients and 200 registered participants of the self-help network for adrenal and pituitary diseases) were contacted by mail. 256 (74%) agreed to participate and received a disease specific and 3...

Treatment of adrenocortical carcinoma (ACC) is still unsatisfactory. As IGF-II and IGF-I receptor are frequently overexpressed in human ACC and inhibitors of the IGF system are currently under preclinical investigation, interference with IGF-signaling might have an additive effect in antitumour treatment. We have therefore analyzed several cytotoxic agents (etoposide, doxorubicine, cisplatin, streptocozin; 0.01–100 μM) on adrenal cell proliferation in vitro an...

Background: The water deprivation test (WDT) with direct or indirect measurement of plasma vasopressin (AVP) is the method of choice for the differential diagnosis of the polydipsia–polyuria syndrome. In theory, direct measurement of AVP is highly attractive but hampered by technical difficulties.Objective: To evaluate the utility of copeptin, a surrogate of AVP secretion, in the diagnostic work-up of the polyuria–polydipsia syndrome, and to co...