Learn more about what type of drug mitotane is

Mitotane is an adrenal cortex-selective cytotoxic drug mainly used to treat adrenocortical cancer (Adrenocortical Carcinoma, ACC). It is a synthetic derivative with a similar structure to the organic pesticide DDT, but its medical uses are completely different. Mitotane can targetedly destroy adrenocortical cells and inhibit the synthesis of adrenal hormones, thereby leading to loss of function and apoptosis of tumor cells. Unlike traditional cytotoxic chemotherapy drugs that mainly kill cells by inhibiting DNA synthesis or cell division, mitotane mainly interferes with the activity of adrenal steroid synthase through metabolic pathways, especially damaging mitochondrial function, thereby achieving anti-cancer effects.

Its biggest feature is that it is highly selective and only targets adrenal tissue, so it is not commonly used in the treatment of other solid tumors. In clinical application, mitotane can be used alone or in combination with multi-drug chemotherapy regimens, especially in the treatment of patients with advanced, metastatic or high-risk postoperative recurrence of ACC. In addition, because mitotane significantly reduces cortisol levels in the body, replacement therapy with exogenous glucocorticoids is often required to prevent adrenal insufficiency.

When using mitotane, patients need to closely monitor plasma drug concentrations and adjust the dose to achieve the best therapeutic effect. At the same time, attention should be paid to the management of drug-related adverse reactions, such as gastrointestinal symptoms, neuropsychiatric disorders, and thyroid dysfunction. Currently, mitotane was originally developed by Bristol Myers Squibb Company and continues to be produced and supplied by HRA Pharma, becoming the only dedicated drug approved for the treatment of ACC worldwide.

In summary, mitotane is an anticancer drug with a unique mechanism that targets adrenal tissue and is one of the important cornerstones of adrenocortical cancer treatment.

Reference materials:https://go.drugbank.com/drugs/DB00648