What are the clinical uses of mitotane? What types of cancer are mainly used to treat?

Mitotane is an adrenocortical inhibitor used primarily to treat adrenocortical carcinoma (ACC), a rare but malignant endocrine tumor. Mitotane can inhibit the synthesis of adrenocortical hormones and has a cytotoxic effect on adrenocortical cells, thereby reducing hormone secretion and inhibiting tumor growth. It is commonly used for unresectable advanced or metastatic ACC, as well as postoperative adjuvant therapy to reduce the risk of recurrence.

In addition to ACC , mitotane can also be used in Cushing's syndrome (Cushing’s syndrome), especially excessive secretion of cortisol due to adrenal tumors or hyperplasia. Mitotane selectively destroys adrenal tissue and reduces cortisol levels, thereby alleviating symptoms of hypercortisolemia such as hypertension, diabetes, and weight gain.

In some cases, mitotane may be used to treat Other steroid hormone-related tumors, such as Some adrenal tumors with abnormal secretion of androgens or estrogens. It can reduce hormone-related symptoms, such as feminization in men or virilization in women, by inhibiting hormone synthesis, but these uses usually require individualized evaluation by a physician.

Since mitotane has a broad inhibitory effect on the adrenal cortex , long-term use may lead to adrenal insufficiency, requiring hormone replacement therapy. In addition, mitotane is metabolized slowly and has a long duration of drug effect. Doctors usually monitor the therapeutic effect based on the patient's blood concentration and adjust the dose to reduce adverse reactions and improve efficacy.