Adrenocortical carcinoma: current treatment options.

Area of Science:

• Oncology
• Endocrinology

Background:

• Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with a poor prognosis.
• Current treatment strategies are limited, necessitating research into novel therapeutic approaches.

Purpose of the Study:

• To review current and future treatment options for adrenocortical carcinoma (ACC).
• To highlight the role of surgery, adjuvant therapy, and chemotherapy in ACC management.

Main Methods:

• Review of current literature on adrenocortical carcinoma (ACC) treatment.
• Analysis of recent findings on adjuvant mitotane, chemotherapy regimens, and emerging targeted therapies.

Main Results:

• Radical surgery is the only curative option for ACC.
• Adjuvant mitotane improves overall survival in high-risk patients, with therapeutic drug monitoring crucial for efficacy.
• Etoposide, doxorubicin, cisplatin with mitotane (EDP-M) is a first-line option for inoperable ACC; gemcitabine, capecitabine, and streptozotocin are second-line choices.
• Temozolomide serves as a third-line option, but targeted therapies have shown unsatisfactory results to date.

Conclusions:

• Adjuvant mitotane is recommended for high-risk ACC patients post-surgery.
• The EDP-M regimen is standard for inoperable ACC, with limited data on subsequent lines of therapy.
• Ongoing clinical trials are evaluating tyrosine kinase and immune checkpoint inhibitors for ACC treatment.