Central Hypothyroidism is Frequent During Mitotane Therapy in Adrenocortical Cancer Patients: Prevalence and Timeline
Authors' conclusion
Mitotane therapy is frequently associated with new onset of central hypothyroidism with a prevalence of 95.5%. Most cases occurred in the first year of treatment. Partial or full recovery of thyroid function occurs in 65.4% of cases. This study supports the importance of systematic monitoring of TSH and free T4 levels during and following discontinuation of mitotane therapy.
Study context
- Population
- Patients exposed to mitotane therapy for adrenocortical cancer, 2 academic centers in Montreal (Canada) and Toulouse (France), 1995–2020; preexisting primary or drug-induced hypothyroidism excluded66 analysed
- Participants
- 83 patients
- Outcome
- Central hypothyroidism: prevalence and time of onset
Methodological details2 academic centers
- 2 academic centers
Main finding
As reported in the abstract
Central hypothyroidism during follow-up
- Developed central hypothyroidism
- 63/66
- Maintained normal thyroid function
- 3/66
- Prevalence of central hypothyroidism
- 95.5%
- Inappropriately normal or low TSH (among 63)
- 56
- Mildly elevated TSH (among 63)
- 7
Observational data: associations, not effects.
Further findings
Time of onset of hypothyroidism
- <3 months
- 33.3%
- 3 to 6 months
- 19.1%
- 6 to 9 months
- 14.3%
- 9 to 12 months
- 9.5%
- After 12 months of exposure (at least)
- 14.3%
- Undetermined time of occurrence
- 6 patients
Recovery from hypothyroidism after stopping mitotane · mainly in the first 2 years after discontinuation
- Stopped mitotane
- 27 patients
- Partial recovery
- 42.3%
- Complete recovery
- 23.1%
- Partial or full recovery
- 65.4%
Original publication
Central Hypothyroidism is Frequent During Mitotane Therapy in Adrenocortical Cancer Patients: Prevalence and Timeline. J Clin Endocrinol Metab. Published 28 February 2023. doi:10.
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