Researchers from Italy and Germany have reported that patients with adrenocortical cancer treated with radical surgery may have a better survival if treated with adjuvant Lysordren (mitotane, O, P’-DDD). The details of this retrospective study appeared in the June 7, 2007 issue of the New England Journal of Medicine.

Adrenocortical carcinoma is a rare cancer that is usually treated with radical surgical with a high rate of disease recurrence. Lysordren is a synthetic derivative of the insecticide DDT that is approved for the treatment of adrenocortical cancer but the documentation of effectiveness is poor.  

These authors evaluated outcomes of 177 patients with adrenocortical cancer who had undergone radical surgery in 55 centers in Italy and Germany. Lysordren was administered to 47 Italian patients while the remainder received only surgery. Control patients were divided into two groups; Italian and German. Recurrence rates were 49% for Lysordren treated patients and 91% and 73%, respectively, for the two control populations. Median relapse-free survival was 42 months for the Lysordren treated patients and 10 months and 25 months, respectively, for the two control groups. Deaths from adrenocortical cancer occurred in 26% of the Lysordren treated patients and 55% and 41%, respectively, for the two control groups. These authors concluded that adjuvant Lysordren may improve recurrence-free survival in patients with surgically resected adrenocortical carcinoma.  

Comments: These rare tumors should be treated in specialized centers where more data can be collected on treatment outcomes. 

References:  Terzolo M, Angeli A, Fassnacht M, et al. Adjuvant mitotane treatment for adrenocortical carcinoma. The New England Journal of Medicine. 2007; 356:2372-2380.