Mitotane associated with cisplatin, etoposide, and doxorubicin in advanced childhood adrenocortical carcinoma - Mitotane monitoring and tumor regression

dc.creatorZancanella, P
dc.creatorPianovski, MAD
dc.creatorOliveira, BH
dc.creatorFerman, S
dc.creatorPiovezan, GC
dc.creatorLichtvan, LL
dc.creatorVoss, SZ
dc.creatorStinghen, ST
dc.creatorCallefe, LG
dc.creatorParise, GA
dc.creatorSantana, MHA
dc.creatorFigueiredo, BC
dc.date2006
dc.dateAUG
dc.date2014-11-16T05:38:04Z
dc.date2015-11-26T16:20:06Z
dc.date2014-11-16T05:38:04Z
dc.date2015-11-26T16:20:06Z
dc.date.accessioned2018-03-28T23:02:43Z
dc.date.available2018-03-28T23:02:43Z
dc.identifierJournal Of Pediatric Hematology Oncology. Lippincott Williams & Wilkins, v. 28, n. 8, n. 513, n. 524, 2006.
dc.identifier1077-4114
dc.identifierWOS:000240111300005
dc.identifier10.1097/01.mph.0000212965.52759.1c
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/57127
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/57127
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/57127
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1267771
dc.descriptionPurpose: To define a mitotane dose for pediatric patients with adrenocortical cancer (ACC) that maintains therapeutic plasma levels (TL) between 14 and 20 mu g/mL and to verify its antitumor efficacy in association with 8 cycles of cisplatin, etoposide, and doxorubicin (CED). Methods: Powdered mitotane was dissolved in a medium chain triglyceride oil and administered to 11 children with ACC (2.4 to 15.4 y of age); an initial low dose was increased to 4 g/m(2)/d. Ten of the 11 children had a germline TP53 R337H mutation. Mitotane plasma levels were determined using high-performance liquid chromatography. Results: The mitotane dose to maintain TL in 7 patients ranged from 1.0 to 5.3 g/m(2)/d. Six children reached mitotane levels of 10 mu g/mL in 3.6 months (1.5 to 5.0mo), whereas 5 children took 8 months (6.5 to 12.5 mo). Minor to partial tumor remission was found in 5 patients (< 1 y) and complete remission was found in 2 patients. Of the 3 patients who are alive at the time of report, 1 patient has been without disease for 16 months, and 2 patients have progressive disease. All patients had recurrent metastatic disease (2 to 9 times). Mitotane toxic effects were nausea, diarrhea, vomiting, neurologic alterations, gynecomastia, a rare case of hypertensive encephalopathy, and CED-related hematologic toxic effects. Conclusions: Mitotane daily dose to maintain TL is variable and monitoring should start 1.5 months after the beginning of treatment. CED combined with mitotane is the best available pharmacologic treatment for ACC, but further studies are required to characterize different profiles of therapeutic response.
dc.description28
dc.description8
dc.description513
dc.description524
dc.languageen
dc.publisherLippincott Williams & Wilkins
dc.publisherPhiladelphia
dc.publisherEUA
dc.relationJournal Of Pediatric Hematology Oncology
dc.relationJ. Pediatr. Hematol. Oncol.
dc.rightsfechado
dc.sourceWeb of Science
dc.subjectmitotane
dc.subjectadrenocortical cancer
dc.subjectchildren
dc.subjectchemotherapy toxicity
dc.subjectTP53 R337H mutation
dc.subjectPhase-ii Trial
dc.subjectBlood-levels
dc.subjectTherapy
dc.subjectO,p'-ddd
dc.subjectChildren
dc.subjectNeoplasms
dc.subjectPlasma
dc.subjectCancer
dc.subjectOrtho,para'-ddd
dc.subjectExperience
dc.titleMitotane associated with cisplatin, etoposide, and doxorubicin in advanced childhood adrenocortical carcinoma - Mitotane monitoring and tumor regression
dc.typeArtículos de revistas


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