CoChat
Sign Up
Cited by 36Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersPituitary Gland Disorders and Treatments

Suramin in adrenocortical cancer: limited efficacy and serious toxicity

Arlt, Wiebke, Reincke, Martin, Siekmann, Lothar, WInkelmann, Werner, Allolio, Bruno·1994·Clinical Endocrinology
DOI 10.1111/j.1365-2265.1994.tb02549.x
Open this paper in CoChat — free account

Abstract

OBJECTIVE: No satisfactory treatment for adrenocortical carcinoma (ACC) is available. We investigated the efficacy and toxicity of suramin in the treatment of metastatic ACC since suramin has been recently reported to be active as a single agent therapy for patients with ACC and prostatic carcinoma. DESIGN: We collected data on 9 patients with metastatic ACC treated with suramin in four centres in Germany between 1987 and 1992. PATIENTS: Nine patients (5 women, 4 men; age range 32-67 years) were included. Biochemical evidence of steroid excess was found in 6/9, in three leading to clinical symptoms (hypertension, hyperglycaemia, hirsutism, gynaecomastia). MEASUREMENTS: Tumour responses were assessed by radiological and biochemical evaluation. Other investigations included regular measurements of blood cell counts, coagulation, hepatic and renal function parameters, and serum suramin concentrations. RESULTS: The patients received cumulative doses ranging from 8.2 to 30.2 g suramin over periods of 1-15 months. 3/9 achieved a partial response, 2/9 disease stabilization and 4/9 experienced progressive disease. Tumour responses were transient. Suramin treatment was without direct influence on steroid excess. Serious side-effects included coagulopathy (6/9), thrombocytopenia (6/9), polyneuropathy (2/9) and allergic skin reactions (4/9); the death of two patients was possibly related to suramin therapy. Both toxicity and tumour response were strongly associated with serum level or cumulative dose of suramin. CONCLUSIONS: (1) Suramin is of antineoplastic efficacy in the treatment of metastatic adrenocortical carcinoma. (2) The clinical use of suramin is limited by a narrow therapeutic window with the risk of serious and possibly lethal toxicity at one extreme, and loss of efficacy at the other. Strict monitoring of suramin serum levels is mandatory aiming at levels between 200 and 250 mg/l. Suramin should not be considered as first-line treatment for metastatic adrenocortical carcinoma. (3) To improve treatment options in adrenocortical carcinoma as well as for further investigation on the usefulness of suramin, controlled prospective trials are urgently needed.

Integrity signals

Registry

Crossref · 10.1111/j.1365-2265.1994.tb02549.x

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Suramin tested in 2 studies led to an overall response rate of approximately 20%, but treatment had a narrow therapeutic range and serious side effects.

    “Subsequently, suramin has been tested in 2 studies where it led to an overall response rate of ∼20%. However, treatment had a narrow therapeutic range and serious side effects (312, 313).”

    From Adrenocortical carcinoma (2014) · cites this paper as [312]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Arlt, W., Reincke, M., Siekmann, L., WInkelmann, W., & Allolio, B.
Affiliations
  • University of Würzburg (DE)
  • University of Bonn (DE)
  • University of Cologne (DE)
Corresponding author
Allolio, Bruno
ORCID
Arlt, Wiebke
Venue
Clinical Endocrinology
Publisher
Wiley
Published
1994-09
Volume
41
Issue
3
Pages
299-307
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.1994.tb02549.x
OpenAlex
W2058797642
Cited by
36
References
55
Citations by year
2024: 1 · 2021: 1 · 2020: 1 · 2013: 1 · 2012: 1
FWCI
3.04
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4946 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Funders
Deutsche Forschungsgemeinschaft
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Keywords
suramin, adrenocortical carcinoma, metastatic adrenocortical carcinoma, antineoplastic efficacy, drug toxicity, coagulopathy, thrombocytopenia, polyneuropathy, cumulative dose, treatment monitoring
MeSH terms
Adrenal Cortex Neoplasms, Adult, Aged, Blood Coagulation, Bone Marrow, Carcinoma, Drug Eruptions, Female, Humans, Kidney, Liver, Male, Middle Aged, Nervous System, Skin, Suramin

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review