Adrenocortical Carcinoma Clinical Trials 2026 — Find Recruiting Studies

About Adrenocortical Carcinoma

Adrenocortical carcinoma is a rare, aggressive malignancy of the adrenal cortex with a highly variable prognosis ranging from curable resected stage I tumours to rapidly fatal stage IV disease with a median survival under 12 months. The molecular landscape is characterised by IGF2 overexpression, somatic TP53 mutations, CTNNB1 activating mutations, and alterations in the CDKN2A and RB1 pathways; germline TP53 mutations cause the Li-Fraumeni syndrome phenotype, particularly relevant in paediatric ACC where up to 80% of Brazilian paediatric patients carry the founder R337H TP53 variant. Mitotane, an adrenolytic drug, remains the cornerstone of adjuvant and palliative systemic therapy, though combination chemotherapy with etoposide, doxorubicin, cisplatin, and mitotane (EDP-M) is used for advanced disease.

Common Clinical Features

Symptoms of cortisol excess (Cushing's syndrome): weight gain, hypertension, diabetes, proximal muscle weakness, and striae Symptoms of androgen excess: virilisation, hirsutism, and menstrual irregularity in women Abdominal or flank pain and a palpable abdominal mass from a large tumour Incidental adrenal mass discovered on imaging for unrelated indications Hypokalaemia and hypertension from aldosterone-secreting tumours (less common) Constitutional symptoms: weight loss, anorexia, and fatigue in advanced disease Back pain and bone pain from skeletal metastases

Clinical Trial Eligibility Tips

What to know before applying to Adrenocortical Carcinoma trials.

Hormonal secretory status — confirmed by 24-hour urinary steroid profile and plasma/urinary catecholamines — must be documented and managed before trial enrolment; uncontrolled hormone excess may be an exclusion criterion.

Mitotane plasma levels (target 14–20 mg/L therapeutic range) and mitotane treatment history are important context for many trials; trials combining mitotane with investigational agents require stable mitotane levels before randomisation.

Comprehensive molecular profiling (including CTNNB1, TP53, CDK4, and MSI status) is increasingly required for biomarker-selected trials — request next-generation sequencing of tumour tissue if not already performed.