Adrenocortical carcinoma (ACC) is a rare neoplasm characterized by poorprognosis. First-line systemic treatments in advanced disease include mitotane,either alone or in combination with chemotherapy. Studies evaluating second-line therapy options have obtained disappointing results. This trial assessed theactivity and toxicity of gemcitabine plus metronomic fluoropyrimidines in heavilypretreated advanced ACC patients. From 1998 to 2008, 28 patients with advancedACC progressing after mitotane plus one or two systemic chemotherapy lines wereenrolled. They received a combination of i.v. gemcitabine (800 mg/m(2), on days 1and 8, every 21 days) and i.v. 5-fluorouracil protracted infusion (200mg/m(2)/daily without interruption until progression) in the first six patients, or oral capecitabine (1500 mg/daily) in the subsequent patients. Mitotaneadministration was maintained in all cases. The rate of non-progressing patients after 4 months of treatment was 46.3%. A complete response was observed in 1patient (3.5%); 1 patient (3.5%) obtained a partial regression, 11 patients(39.3%) obtained a disease stabilization and 15 patients (53.7%) progressed.Treatment was well tolerated, with grade III and IV toxicities consisting ofleukopenia in six patients (21.4%), thrombocytopenia in one patient (3.5%), andmucositis in one patient (3.5%). Median time to progression and overall survival in the patient population were 5.3 (range: 1-43) and 9.8 months (range: 3-73)respectively. Gemcitabine plus metronomic fluoropyrimidines is a well-toleratedand moderately active regimen in heavily pretreated ACC patients.
|Numero di pagine||9|
|Stato di pubblicazione||Published - 2010|