Mitotane’s mechanism of action

Mitotane (Mitotane) is an adrenal cytotoxic agent with an unknown mechanism of action. Mitotane alters the peripheral metabolism of steroids and directly inhibits the adrenocortex. A decrease in 17-hydroxycorticosteroids and an increase in the formation of 6-beta-hydroxycortisol have been reported in the absence of a decrease in corticosteroid concentrations. The adrenal cortex produces steroid hormones. When cancer develops in this area, levels of these hormones increase, causing symptoms of the disease. The active substance in Mitotane is thought to prevent the adrenal cells from working properly by damaging their mitochondria (the energy-producing components) and reducing the production of some steroid hormones. It may also alter the breakdown of these hormones.