Can Mitotane be used to treat lung cancer?

In the field of tumor treatment, Mitotane is often misunderstood as a "broad-spectrum anti-cancer drug". However, judging from the positioning of international guidelines and professional databases, the indications of mitotane are very clear. It is only used for hormonal control related to adrenocortical cancer (ACC; adrenal cancer) and Cushing's syndrome, and is not suitable for the treatment of lung cancer. Its research and development purpose, target of action and safety assessment all revolve around the adrenocortical system, which determines that its scope of application is highly specific.

Mitotane was originally developed for its ability to selectively destroy adrenocortical cells, a mechanism that does not have the same sensitivity in other tissues, including lung tissue. Therefore, overseas authoritative information clearly states that mitotane cannot be used as a treatment for lung cancer. The treatment system for lung cancer includes targeted drugs, immunotherapy, chemotherapy and radiotherapy, etc., but its biological basis is completely different from the action pathway of mitotane.

One reason for patient confusion, however, is that some lung cancers may develop "ectopic ACTH secretion," resulting in a hormone disorder similar to Cushing's syndrome. At this time, mitotane can be used to control symptoms of hormone overdose, but this is "treatment of complications" rather than "treatment of lung cancer itself." Professional information often mentions this as a special use case, but it does not change the essence that mitotane is not an anti-tumor drug for lung cancer.

The real applicable population of mitotane mainly includes patients with inoperable functional or non-functional ACC As well as for the control of Cushing's syndrome. When ACC cannot be completely removed, mitotane can slow the progression of the disease by suppressing hormone production and damaging adrenocortical cells. In people with Cushing's syndrome, it helps reduce cortisol levels and relieve symptoms. Therefore, its scope of use is limited to the field of endocrine tumors rather than extensive tumor treatment.

Reference materials:https://go.drugbank.com/drugs/DB00648