Does Adjuvant Mitotane Impact Cure Rates in Adrenocortical Carcinoma? Insights From the ICARO-GETTHI/SEEN Registry
Main finding · RecurrenceResult — go to the resultHazard ratio 0.61 95% CI 0.39–0.95Authors' conclusion
This study underscores the intriguing possibility that adjuvant mitotane delays recurrence, yet questions remain as to its curative capacity. The early benefit suggests a cytostatic effect, but certain subgroups-especially males, younger individuals, and those with high-risk tumors-may experience a more durable outcome. Further research is needed to explore mitotane's curative potential in ACC management.
Study context
- Population
- Patients with nonmetastatic adrenocortical carcinoma (ACC) after resection, ICARO-GETTHI/SEEN registry, 36 Spanish hospitals
- Participants
- 244 patients
- Exposure
- Adjuvant mitotane vs no adjuvant mitotane
- Mitotanen = 133
- Outcome
- Recurrence
Methodological detailsregistry-based, multicentre, Therapeutic mitotane levels monitored in 84%
- Registry-based
- Multicentre
- Therapeutic mitotane levels monitored in 84%
Main finding
As reported in the abstract
Hazard ratio
0.61
95% CI 0.39–0.95
Mitotanevs No mitotane
HR 0.61 (95% CI 0.39–0.95)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Recurrence, male patientsEffect modification analysis | 0.33 (0.16–0.69) | |
| Recurrence, venous invasionEffect modification analysis | 0.47 (0.27–0.82) | |
| 0.10.31310Hazard ratio (log scale) |
Estimated 30-year cure rate (cure fraction)
- Estimated 30-year cure rate
- 32.5% (95% CI, 23.4%-45.0%)
Recurrence, other subgroups
- Significant benefit in younger patients and tumors with higher Ki-67% (continuous); potential synergy with radiotherapy
Original publication
Does Adjuvant Mitotane Impact Cure Rates in Adrenocortical Carcinoma? Insights From the ICARO-GETTHI/SEEN Registry. J Clin Endocrinol Metab. Published 14 February 2025. doi:10.
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