Cytotoxic therapy with etoposide and cisplatin in advanced adrenocortical carcinoma

Adrenocortical carcinoma (ACC) is a rare tumour with a poor prognosis. Cisplatin is the most widely tested cytotoxic agent in this disease. A total of 18 patients with advanced ACC were enrolled. Cytotoxic therapy consisted of etoposide (VP16) (100 mg m^-2 day^-1 on days 1-3) and cisplatin (100 mg m^-2 day^-1 on day 1) every 4 weeks. Mitotane treatment was maintained during chemotherapy in 14 patients. A complete response was observed in three cases and a partial response in three cases, giving an overall response rate of 33%. Tumour response was observed in three of the six patients with progressive disease during treatment with mitotane given at an effective dosage, as shown by serum levels > 14 mg l^-1. Toxic effects were as expected and were non-life-threatening; no treatment interruption was required.