Endocrine Abstracts

Background: Mitotane is the only approved treatment for advanced adrenocortical carcinoma and was shown to inhibit Sterol-O-Acyl transferase 1 (SOAT1) which leads to the depletion of cholesterol esters and increase of free cholesterol in the ACC cell line H295R. Downstream activation of the endoplasmic reticulum stress (ER-stress) pathway results in decreased adrenocortical cell viability.Aim: To better characterize the effects of SOAT1 inhibition in ACC...

Introduction: Adrenocortical carcinoma (ACC) is an aggressive tumour with unsatisfactory treatment options in advanced disease. Activation of epithelial to mesenchymal transition (EMT) has been described as causative of metastatic spread in human cancers. New drugs were developed targeting EMT with a focus on FGF/FGFR signalling. We here asked whether EMT is relevant in ACC.Methods: We analysed 6 normal adrenal glands (NAG), 40 adrenocortical adenomas (A...

Background: The recent ESE-ENSAT guidelines on adrenocortical carcinoma (ACC) indicated new treatment options for patients with “high risk for recurrence” as one of the major research topics for the field. However, since almost no data were available on the use of cytotoxic drugs in an adjuvant setting, no clear recommendation could be given. Here we report our experience with adjuvant platin-based therapy since 2002 at the University of Würzburg and MD Anders...

Objective: The saline infusion test (SIT) is a standard confirmatory test for primary aldosteronism (PA) and based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Due to the more widespread use of liquid chromatography tandem mass spectrometry (LC-MS/MS) in clinical routine, we aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the d...

Background: Circulating levels of the appetite-suppressing and glucoregulatory gut hormones glucagon-like peptide 1 (GLP-1) and peptide tyrosine tyrosine 3–36 (PYY3–36) are markedly increased after Roux-en-Y gastric bypass surgery (RYGB), which may contribute to some of its profound metabolic benefits in morbidly obese individuals.Objectives: To directly compare the metabolic effects of chronic systemic administration of the clinic...

Objective: To document influences of sampling of blood under supine fasting versus seated non-fasting conditions on diagnosis of pheochromocytoma using plasma concentrations of normetanephrine, metanephrine and methoxytyramine (P-NMN/MN/MTY).Design and methods: P-NMN/MN/MTY were measured by liquid chromatography with tandem mass spectrometry in 695 patients at five centers, two of which complied with requirements for supine sampling after an overnight fa...

Introduction: Current medical treatment of adrenocortical carcinoma (ACC) is based on mitotane alone or in combination with cytotoxic chemotherapy. However, very little is known about the pharmacokinetic properties of mitotane and dosing schedules are based on clinical experience only. The aim of this study was to investigate the relationship between mitotane dose and plasma concentration comparing two pre-defined treatment regimens. Secondary objectives were to evaluate safet...

Background: No randomized trials have been conducted in adrenocortical carcinoma (ACC) patients. Treatment recommendations for this rare but aggressive disease have been based on data from small phase II trials. We have now performed the first randomized phase III trial, comparing etoposide, doxorubicin, cisplatin, plus mitotane (EDP-M) against streptozotocin plus mitotane (Sz-M).Methods: Three-hundred and four chemotherapy-naive patients with ACC not am...

While bariatric surgery is the most effective treatment strategy to maintain long-term weight-loss and to improve survival, it has not been shown, that bariatric surgery is as effective in craniopharyngeoma patients with hypothalamic obesity. We retrospectively analyzed weight loss and metabolic parameters in 7 craniopharyngeoma patients and 14 controls who underwent gastric banding surgery in five centers in Germany and Austria. The last before and the first patient after the...

Introduction: Surgery is the established first line treatment in adrenocortical carcinoma (ACC). For benign adrenal tumours, laparoscopic adrenalectomy (LA) has become the treatment of choice. However, the role of LA in ACC remains highly controversial. Data from the German ACC Registry were used to evaluate the technical feasibility of LA in ACC and to compare the long-term outcome after LA with the results of open adrenalectomy (OA).Methods: Out of 521...