Streptozocin and o,p'DDD in the treatment of adrenocortical cancer patients: Long-term survival in its adjuvant use

Background: To evaluate the efficacy of streptozocin and o,p'DDD (SO) in ad renocortical cancer (ACC) patients since other chemotherapeutic regimens ha ve limited effects. Patients and methods: We performed a phase II study with SO therapy in 40 A CC patients (median age 44 years). Oral o,p'DDD administration (1-4 g/d, ev ery day) was given together with intravenous streptozocin (1 g/d for five d ays, thereafter 2 g once every three weeks). 5HT(3)-receptor blocker was us ed as standard premedication for streptozocin. Results: The SO therapy was found to have significant effects on disease-fr ee interval (P = 0.02) as well as on survival (P = 0.01) in adjuvantly trea ted cases (n = 17) in comparison to the patients who did not get any therap y after complete resection (n = 11). Complete or partial response was obtai ned in 36.4% of patients with measurable disease (n = 22). The overall two- year and five-year survival rates were 70% and 32.5%, respectively. The pre sence of metastases at diagnosis was identified as a poor prognostic factor (P = 0.02). Conclusions: The present study necessitates further randomized clinical stu dy of SO therapy in the treatment of ACC, mainly as adjuvant treatment imme diately after curative intended surgery, and could be developed into a regu lar treatment regimen.