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Cited by 421Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersRenal cell carcinoma treatment

Management of patients with adrenal cancer: recommendations of an international consensus conference

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Schteingart, D E, Doherty, G M, Gauger, P G, Giordano, T J, Hammer, G D, Korobkin, M, Worden, F P·2005·Endocrine Related Cancer
DOI 10.1677/erc.1.01029
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Abstract

Adrenocortical carcinomas are rare, highly malignant tumors that account for only 0.2% of deaths due to cancer. Given the limited number of patients seen in most medical centers with this diagnosis, series usually reported are small and clinical trials not randomized or blinded. In an attempt to answer important questions concerning the management of patients with adrenal cancer, a consensus conference was organized and held at the University of Michigan in Ann Arbor, MI, 11-13 September 2003, with the participation of an international group of physicians who had reported on the largest series of patients with this disease and who had recognized basic and clinical research expertise in adrenal cortical cancer. Totally 43 questions were addressed by the presenters and recommendations discussed in plenary and breakout sessions. Evidence for the recommendations of this conference was at the 2-4+ level and based on available literature and participants' experience. In addition to setting up guidelines in specific areas of the diagnosis and treatment of adrenal cancer, the conference recommended and initiated the planning of an international prospective trial for treatment of patients with adrenal cancer in stages III and IV. In terms of new therapies, first trials of dendritic cell therapy in human subjects with adrenal cancer have been started, but it is too early to comment on efficacy. Different strategies of immunotherapy, including DNA vaccination are currently being tried in animal models. There are no clinical gene therapy trials for human adrenal cortical cancer. The adrenals are a preferred target for adenovirus and the results of gene therapy in preclinical studies are promising. In addition, there is evidence that histone deacetylase inhibitors can further enhance the rate of adenoviral infectivity in human adrenal cancer cells. Testing of retroviral vectors, non-viral vectors, small interfering RNA technology, and combined approaches could be performed in various laboratories. Anti-angiogenic substances have only been applied in preclinical studies. The use of these and other agents in the treatment of adrenal cancer should be hypothesis-driven and based on a thorough analysis of tumor biology.

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  • 1.3% of all childhood cancers are ACCs, as opposed to 0.02% to 0.2% of adult cancers, confirming a higher relative incidence early in life.

    “The fact that 1.3% of all childhood cancers are ACCs as opposed to 0.02% to 0.2% of adult cancers confirms a higher relative incidence early in life (12, 15–17).”

    From Adrenocortical carcinoma (2014) · cites this paper as [15]

  • Mitotane remains the only drug approved by the U.S. Food and Drug Administration and European Medicine Executive Agency for treatment of ACC.

    “Mitotane remains the only drug approved by the U.S. Food and Drug Administration and European Medicine Executive Agency for treatment of ACC (15).”

    From Adrenocortical carcinoma (2014) · cites this paper as [15]

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Research works printed but not linked: 5

  1. Gross MD, Shapiro B, Bouffard J, Glazer GM, Francis IR, Wilton GP, Kahfagi F & Sonda LP 1988 Distinguishing benign and malignant euadrenal masses. Annals of Internal Medicine 109 613-618.
  2. Haak HR, Hermans J, VandeVelde CJH, Lentjez EG, Goslings BM, Fleuren GJ & Krans HM 1994 Optimal treatment of adrenal cortical carcinoma with mitotane: results in a consecutive series of 96 patients. British Journal of Cancer 69 947-951.
  3. Lin SR, Lee YJ & Tsai JH 1994 Mutations of the p53 gene in human functional adrenocortical neoplasms. Journal of Clinical Endocrinology and Metabolism 78 483-491.
  4. McNicol AM, Nolan CE, Struthers AJ, Farguharson MA, Hermans J & Haak HR 1997 Expression of p53 in adrenocortical tumours: clinicopathological correlations. Journal of Pathology 181 146-152.
  5. Eds AN Margioris & G Chrousos. Totowa, NJ: Humana Press.

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Authors
Schteingart, D. E., Doherty, G. M., Gauger, P. G., Giordano, T. J., Hammer, G. D., Korobkin, M., & Worden, F. P.
Affiliations
  • University of Michigan (US)
  • 1Surgery,
  • 2Pathology and
  • Departments of Internal Medicine,
ORCID
Venue
Endocrine Related Cancer
Publisher
Bioscientifica
Published
2005-09-01
Volume
12
Issue
3
Pages
667-680
ISSN
  • 1351-0088 (ISSN-L)
  • 1479-6821
DOI
10.1677/erc.1.01029
OpenAlex
W2095699011
Cited by
421
References
74
Citations by year
2026: 7 · 2025: 3 · 2024: 10 · 2023: 13 · 2022: 16 · 2021: 25 · 2020: 25 · 2019: 19 · 2018: 15 · 2017: 13 · 2016: 14 · 2015: 31 · 2014: 42 · 2013: 26 · 2012: 32
FWCI
13.79
Type
journal article
Language
en
Open access
Locations
  • Endocrine Related Cancer (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Michigan
  • National Institutes of Health
  • University of Michigan Comprehensive Cancer Center
  • National Center for Research Resources (M-01RR00042)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
Keywords
adrenocortical carcinoma, dendritic cell immunotherapy, immunotherapy, DNA vaccine, gene therapy, adenoviral vector, histone deacetylase inhibitors, anti-angiogenic therapy, tumor biology
MeSH terms
Adrenal Gland Neoplasms, Humans, Neoplasm Staging

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