title: Ketoconazole. Use in the treatment of ectopic adrenocorticotropic hormone production and Cushing's syndrome in small-cell lung cancer.
abstract: Recently, ketoconazole, an imidazole derivative with antifungal properties, has been shown to inhibit adrenal corticosteroid and androgen production. We treated a patient with small-cell lung cancer and Cushing's syndrome secondary to ectopic secretion of adrenocorticotropic hormone in whom it was necessary to discontinue chemotherapy. The patient was treated with ketoconazole, with a resultant reduction in urinary free cortisol and ketosteroid excretion and improvement in electrolyte balance. Ketoconazole may be a useful adjunct in the treatment of small-cell lung cancer or other malignancies associated with excessive corticosteroid production or as a hormonal therapy in breast or prostatic cancer.
authors.forename: F A
authors.initials: FA
authors.lastname: Shepherd
authors.forename: B
authors.initials: B
authors.lastname: Hoffert
authors.forename: W K
authors.initials: WK
authors.lastname: Evans
authors.forename: G
authors.initials: G
authors.lastname: Emery
authors.forename: J
authors.initials: J
authors.lastname: Trachtenberg
mesh_terms: D015068:17-Ketosteroids / Q000652:urine; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis*; D018288:Carcinoma, Small Cell / Q000150:complications* / Q000378:metabolism; D003480:Cushing Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D007654:Ketoconazole / Q000494:pharmacology / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood
chemical_list: D015068:17-Ketosteroids; D000324:Adrenocorticotropic Hormone; D007654:Ketoconazole; D011188:Potassium; D006854:Hydrocortisone