Case Report: Exceptional Response to Second Line Temozolomide Therapy in a Patient With Metastatic Adrenocortical Carcinoma.
Adrenal Cortex Neoplasms
/ drug therapy
Adrenocortical Carcinoma
/ drug therapy
Adult
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cisplatin
/ administration & dosage
Doxorubicin
/ administration & dosage
Etoposide
/ administration & dosage
Female
Humans
Mitotane
/ administration & dosage
Prognosis
Remission Induction
Temozolomide
/ administration & dosage
Young Adult
ACC
adrenal tumor
alkylating drug
progesterone
treatment
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
02
2021
accepted:
31
03
2021
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
21
12
2021
Statut:
epublish
Résumé
In a recently published retrospective case series, Temozolomide was found active as second line approach in advanced ACC patients. The disease control rate obtained, however, was short-lived. We report here an ACC patient with extensive metastatic disease who obtained a remarkable long lasting response with this alkylating agent. a 22-year-old female patient with ACC presented at our Medical Oncology Department in poor general condition due the presence of extensive metastatic pulmonary involvement. The disease had progressed to etoposide, doxorubicin and cisplatin plus mitotane therapy. Second line temozolomide therapy was prescribed leading to a progressive improvement of patient general conditions. The disease restaging after 12 cycles revealed a complete response of lung lesions and the patient was free from progression for 14+ months. Temozolomide therapy could be exceptionally efficacious in the management of ACC patients. The molecular mechanisms of sensitivity and resistance to this drug should be carefully studied, in order to select the patients destined to obtain a significant clinical benefit to the drug.
Sections du résumé
Background
In a recently published retrospective case series, Temozolomide was found active as second line approach in advanced ACC patients. The disease control rate obtained, however, was short-lived. We report here an ACC patient with extensive metastatic disease who obtained a remarkable long lasting response with this alkylating agent.
Case Presentation
a 22-year-old female patient with ACC presented at our Medical Oncology Department in poor general condition due the presence of extensive metastatic pulmonary involvement. The disease had progressed to etoposide, doxorubicin and cisplatin plus mitotane therapy. Second line temozolomide therapy was prescribed leading to a progressive improvement of patient general conditions. The disease restaging after 12 cycles revealed a complete response of lung lesions and the patient was free from progression for 14+ months.
Conclusion
Temozolomide therapy could be exceptionally efficacious in the management of ACC patients. The molecular mechanisms of sensitivity and resistance to this drug should be carefully studied, in order to select the patients destined to obtain a significant clinical benefit to the drug.
Identifiants
pubmed: 33967965
doi: 10.3389/fendo.2021.674039
pmc: PMC8101262
doi:
Substances chimiques
Etoposide
6PLQ3CP4P3
Mitotane
78E4J5IB5J
Doxorubicin
80168379AG
Cisplatin
Q20Q21Q62J
Temozolomide
YF1K15M17Y
Types de publication
Case Reports
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
674039Informations de copyright
Copyright © 2021 Cosentini, Turla, Carminati, Grisanti, Ferrari, Laganà, Rosti, Sigala and Berruti.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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