A New Class of Anticancer Drugs

Adrenocortical carcinoma generally carries a poor prognosis. No effective therapies have emerged to treat or cure this disease. Radical surgical excision is the treatment of choice for cancers that have not spread to other organs. Surgery is the treatment of choice, except when there is evidence of distant spread

Unresectable or widespread tumors may be palliated by anti-hormonal therapy with mitotane, systemic chemotherapy, or radiation therapy. Despite these treatments, survival for patients with stage IV tumors is usually less than 9 months. Because of the frequent recurrence of adrenal carcinoma, mitotane has been advocated for all patients after apparent complete surgical excision, even though the efficacy of adjuvant mitotane remains disappointing. Drug toxicity remains a difficult problem; prolonged treatment with mitotane is often limited by gastrointestinal and neurologic toxicity. Mitotane is metabolized into an acyl chloride that binds to important macromolecules in the mitochondria, causing mitochondrial destruction and necrosis of adrenocortical cells. APL scientists have described a new class of anticancer drugs that may destroy the cancer cell from within. We believe that this new class of compounds will be taken up preferentially by adrenal tumor cells in a similar manner as mitotane is concentrated in adrenal cells.

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