{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:20:27Z","timestamp":1784557227835,"version":"3.55.0"},"reference-count":44,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,30]]},"abstract":"<jats:p>Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin, and cisplatin (EDP). Although both therapies are widely used, markers of response are still lacking. Since inflammation-based scores have been proposed as prognostic factors in ACC, we aimed to investigate their role in predicting the response to first-line chemotherapy.<\/jats:p>\n                  <jats:p>We performed a retrospective analysis of patients with advanced ACC treated with mitotane monotherapy or EDP \u00b1 mitotane. Clinical parameters (tumour stage at diagnosis, resection status, Ki67, time from diagnosis to treatment start, performance status, plasma mitotane levels, time in mitotane target \u2265 80%, clinically overt cortisol hypersecretion), and pretreatment inflammation-based scores (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio) were investigated. The primary endpoints were overall survival (OS) and time-to-progression (TTP) from treatment initiation, the secondary endpoint was the best objective response to treatment.<\/jats:p>\n                  <jats:p>\n                    We included 90 patients (59%\u2009=\u2009women, median age\u2009=\u200951 years) treated with mitotane monotherapy (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940) or EDP \u00b1 mitotane (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950). In the mitotane monotherapy cohort, NLR \u2265 5 and PLR \u2265 190 predicted shorter OS (hazard ratio (HR): 145.83, 95% CI: 1.87\u201311,323.83; HR: 165.50, 95% CI: 1.76\u201315,538.04, respectively), remaining significant at multivariable analysis including clinical variables. NLR was also associated with shorter TTP (HR: 2.58, 95% CI: 1.28\u20135.20), but only at univariable analysis. Patients with NLR \u2265 5 showed a worse treatment response than those with NLR &lt; 5 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.040). In the EDP \u00b1 mitotane cohort, NLR \u2265 5 predicted shorter OS (HR: 2.52, 95% CI: 1.30\u20134.88) and TTP (HR: 1.95, 95% CI: 1.04\u20133.66) at univariable analysis.\n                  <\/jats:p>\n                  <jats:p>In conclusion, inflammation-based scores, calculated from routinely measured parameters, may help predict response to chemotherapy in advanced ACC.<\/jats:p>","DOI":"10.1530\/erc-22-0372","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T09:51:19Z","timestamp":1675072279000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":8,"title":["Inflammation-based scores as predictors of treatment response in advanced adrenocortical carcinoma"],"prefix":"10.1530","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1035-8551","authenticated-orcid":true,"given":"Alessandra","family":"Mangone","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"},{"name":"Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Altieri","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Detomas","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Prete","sequence":"additional","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haider","family":"Abbas","sequence":"additional","affiliation":[{"name":"Oncology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Asia","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-6053","authenticated-orcid":true,"given":"Yasir S","family":"Elhassan","sequence":"additional","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"},{"name":"Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5020-2071","authenticated-orcid":true,"given":"Cristina L","family":"Ronchi","sequence":"additional","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK"},{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Minerva Endocrinology","first-page":"203","article-title":"Mitotane treatment in adrenocortical carcinoma: mechanisms of action and predictive markers of response to therapy","volume":"47","author":"Altieri","year":"2022","unstructured":"Altieri BLalli EFaggiano A2022Mitotane treatment in adrenocortical carcinoma: mechanisms of action and predictive markers of response to therapy. 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