title: No evidence for relevant QT interval prolongation in mitotane-treated patients with adrenocortical carcinoma.
abstract: OBJECTIVE
  We designed a single-center retrospective study to assess the QT interval duration and to describe cardio vascular events among patients treated with mitotane for a adrenocortical carcinoma (ACC).
  
  
  METHODS
  We selected 14 patients (6 males and 8 females) that met the following criteria: ACC treated with mitotane, for whom an electrocardiogram (ECG) at baseline (before mitotane initiation) was available and for whom at least one ECG was available during the course of mitotane therapy together with a concomitant mitotane plasma level determination.
  
  
  RESULTS
  Mean mitotane plasma level at baseline and after treatment showed a significant increase (mean level increased from 0 to 14.9±2 mg/l). At baseline and before mitotane was initiated all QTc intervals were <450 msec for men and <460 msec for women. During the treatment phase with mitotane, no QTc>470 msec was found in any patients respectively for men and women. In addition, no patient showed any significant QTc prolongation (>5% or >10 msec) at any time during mitotane treatment. During a mean follow-up of 15.9±3.5 months (range 2-45 months). No cardiovascular deaths or hospitalization for cardiovascular events was documented. No torsades de pointes were documented on ECG. No syncope, dizziness, heart failure were observed during follow up. Six out of 14 patients died during the follow-up, in five cases due to the progression of the disease, one patient died suddenly at home during followup.
  
  
  CONCLUSIONS
  This short and retrospective series shows no evidence that mitotane induce any QT prolongation, even when plasma levels are well above the therapeutic window.
authors.affiliation: Department of Cardiology, Saint-Antoine University, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Ederhy
authors.forename: A
authors.initials: A
authors.lastname: Cohen
authors.forename: G
authors.initials: G
authors.lastname: Dufaitre
authors.forename: R
authors.initials: R
authors.lastname: Chaderevian
authors.forename: H
authors.initials: H
authors.lastname: Abbas
authors.forename: X
authors.initials: X
authors.lastname: Bertagna
authors.forename: R
authors.initials: R
authors.lastname: Libé
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000188:drug therapy*; D018268:Adrenocortical Carcinoma / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D008939:Mitotane / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D008939:Mitotane