Hormone Therapy for Adrenal Cancer

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Drugs other than chemo (mitotane) may be used to decrease the  hormones made by the adrenal cancer or to lower the effects of the hormones. Treatment with some of these drugs may need to be supervised by an endocrinologist (hormone doctor) because it might affect several hormone systems and might make it necessary to replace other hormones.

Drugs used to manage:

  • Elevated cortisol: metyrapone, ketoconazole, mifepristone, etomidate
  • Elevated aldosterone: spironolactone, eplerenone, amiloride
  • Elevated testosterone: bicalutamide, finasteride, spironolactone
  • Elevated estrogen: tamoxifen

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References

Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

Angelousi A, Dimitriadis GK, Zografos G, Nolting S, Kaltsas G, Grossman A. Molecular targeted therapies in adrenal, pituitary and parathyroid malignancies. Endocrine-related Cancer. 2017;24(6):R239-R259.

Berruti A, Fassnacht M, Baudin E, et al. Adjuvant therapy in patients with adrenocortical carcinoma: A position of an international panel. J Clin Oncol. 2010;28(23):e401-402; author reply e403. Epub 2010 Jun 21.

Castinetti F, Fassnacht M, Johanssen S, et al. Merits and pitfalls of mifepristone in Cushing's syndrome. Eur J Endocrinol 2009; 160:1003.

Else T, Williams AR, Sabolch A, et al. Adjuvant therapies, patient and tumor characteristics associated with survival of adult patients with adrenocortical carcinoma. J Clin Endocrinol Metab. 2013 Dec 3. [Epub ahead of print].

Lirov R, Tobias E, Lerario AM, Hammer GD. Adrenal tumors In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins 2015: Chapter 84.

National Cancer Institute. Physician Data Query (PDQ). Adrenocortical Carcinoma Treatment.  8/25/2024. Accessed at: https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq  on July 13, 2024.

National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Neuroendocrine and Adrenal Tumors, Version 2.2024--August 1, 2024. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf on July 17, 2024.

Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancer of the endocrine system In: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, PA. Elsevier: 2014: 1112-1142.

 

 

Last Revised: October 1, 2024

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