Mitotane generally requires several courses of treatment to see effects.

Mitotane (Mitotane) is a specific drug used to treat adrenocortical cancer. Its onset of action is different from that of most anti-tumor drugs. It is a treatment method that has a slow onset of action and requires long-term maintenance of blood drug concentration. Clinically, there is no fixed concept that is clearly divided into "several courses of treatment". Instead, the duration of medication and whether the effective blood concentration is reached are important basis for judging the efficacy. Therefore, it is often difficult for patients to see immediate obvious effects in the short term.

From a time perspective, most studies and clinical experience show that mitotane usually needs to be taken continuously for several weeks to several months before the blood concentration can gradually reach the therapeutic window range. It usually takes about 2~3 months, and even longer for some patients. At this stage, the treatment goal is mainly to establish stable and effective drug levels, and efficacy indicators such as tumor shrinkage or hormone secretion control often appear gradually after this.

In different treatment scenarios, the effective time also varies. When used as postoperative adjuvant therapy, mitotane is more used to reduce the risk of recurrence, and its efficacy is manifested in the improvement of long-term recurrence-free survival rate rather than short-term imaging changes; in advanced or metastatic adrenocortical cancer, some patients may only observe stable disease or remission on imaging or hormone levels after continuous treatment for 3 to 6 months.

It is important to emphasize that the efficacy of mitotane is closely related to dose adjustment and tolerability. Due to the many adverse reactions of this drug, many patients need to gradually increase the dose in the initial stage, which will also affect the onset of effect. Therefore, blood drug concentration, liver function and hormone levels should be regularly monitored during use, and efficacy evaluation points should be fully communicated with doctors. In general, mitotane is a treatment drug that requires patience and is oriented towards medium and long-term effects.

Keyword tags: mitotane, course of treatment, efficacy evaluation, adrenocortical cancer, plasma concentration, onset of effect, postoperative adjuvant, advanced tumors, dose adjustment, long-term treatment.

Reference materials:https://pubmed.ncbi.nlm.nih.gov/?term=mitotane