Is mitotane a chemotherapy drug or a targeted drug?

Mitotane (trade name: Lysodren) plays an important role in the treatment of adrenocortical cancer.

Mitotan exerts its pharmacological effects mainly by interfering with the mitochondrial function and sterol metabolism pathway of adrenocortical cells. It inhibits the mitochondrial respiratory chain activity of adrenocortical cells and reduces the production of steroid hormones such as cortisol, aldosterone and androgens. In addition, mitotane also inhibits the activity of sterol-O-acyltransferase1 (SOAT1), leading to the accumulation of intracellular cholesterol and fatty acids, inducing endoplasmic reticulum stress response, thereby promoting cancer cell apoptosis.

From the perspective of pharmacological mechanism, mitotane does not directly act on specific molecular targets of tumor cells, as some targeted drugs do. Instead, it affects tumor cell growth and proliferation through broad cytotoxic effects. This mechanism of action makes mitotane more likely to be classified as a chemotherapy drug rather than a targeted drug.

Mitotane is widely used clinically to treat inoperable, functional and non-functional adrenocortical carcinomas, as well as adrenocortical hyperplasia and hypercortisolism. It slows tumor growth and relieves symptoms by interfering with the function of adrenocortical cells and reducing the production of steroid hormones. Although mitotane is similar to targeted drugs in some aspects (eg, targeting specific organs or cell types), its mechanism of action does not rely on the recognition and binding of specific molecular targets.

References:

https://www.cancerresearchuk.org/about-cancer/treatment/drugs/mitotane-lysodren

xa0