Adrenal Gland Cancer

Published Date : Jan 2024
Category : Oncology
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"Exploring Trends: Advancements and Breakthroughs in Adrenal Gland Cancer Research"

Regarding cortical adenomas and pheochromocytomas, adrenal cortical carcinomas (ACC) are much less prevalent lesions. According to NCBI, the annual incidence of ACC is between 0.5 and 2 per million persons worldwide. However, 0.02 to 0.2% of all cancer-related deaths are caused by this neoplasm. Adrenocortical carcinomas are extremely aggressive lesions that occasionally are functional and exhibit virilization or Cushing syndrome. ACC is typically non-functional and manifests as an abdominal lump or an unintentional discovery.

Furthermore, according to the Surveillance, Epidemiology, and End Results (SEER) database, the estimated annual incidence of cancer is 0.72 per million cases, which accounts for 0.2% of all cancer-related fatalities in the US.

Although most adrenocortical tumors, whether benign or malignant, are monoclonal tumors, adrenocortical hyperplasia is a polyclonal process. This suggests that genetic alterations at genomic loci may be involved in the development of adrenal tumors.

Compared to malignant tumors, benign adrenal tumors grow slower. According to research, the growth rate ranges from 0.3 to 2.8 mm annually, while malignant adrenal tumors have a growth range of 5.8 to 395.4 mm annually.

As per DiseaseLandscape Insights (DLI) analysis, an estimated 600 Americans receive an adrenocortical cancer diagnosis each year. Compared to an adrenal adenoma, a noncancerous tumor most frequently detected in middle-aged and older persons, this type of cancer is far less prevalent. An adrenal gland neoplasm typically causes a person to hit 50 - 60 years old.

The main cause of Adrenal gland cancer still has an unclear etiology, when alterations, or mutations, occur in an adrenal gland cell's DNA, adrenal cancer develops. According to the CDC Inherited mutations that render the TP53 tumor suppressor gene inactive are the cause of the Li-Fraumeni syndrome. About 1 in 20 adult cases of adrenal cancer are caused by this syndrome, but it frequently results in adrenal cancer in children as well. Also, 8 of every ten incidences of adrenal cancer in children are caused by Li-Fraumeni syndrome. Many additional adrenal tumors have also been reported to contain TP53 gene alterations that were acquired after birth (not inherited).

Rarely, adrenal cancer starts in one or both tiny, triangular glands called adrenal kidneys, which are situated above the kidneys. Hormones produced by the adrenal glands instruct in all the body's organs and tissues.

Adenoma adrenal gland symptoms include weight gain, weakness in the muscles, hormonal changes in both men and women, pink or purple skin stretch marks, nausea, vomiting, bloating in the abdomen, back discomfort, fever, and loss of appetite.

For early-stage adrenal carcinoma, the five-year survival rate ranges from ~50% to 60%. On the other hand, only about 50% of patients with adrenal cancer survive rate. This is because, when a tumor is identified, it has already spread outside of the adrenal gland in more than two-thirds of cases.

Currently, to treat Adrenal tumors, there have been targeted drug therapies which include chemotherapy and hormonal therapy drugs. In many cases, a chemotherapeutic agent that was initially developed to treat Adrenal carcinoma is officially used to cure the disease. This brings many opportunities for market players to invest in this sector and gain new business value.

Disease Landscape Insights facilitates making informed choices in the field of medical technology, treatments, and diagnostics where different technologies and remarkable advancements transforming the landscape leading to higher growth.

Diagnostic Analysis

"Diagnostic Advances for Adrenal Carcinoma: Enabling Patient Care"

One of the main drivers for the growth of the global adrenal gland cancer diagnostic market is the growing popularity of advanced techniques such as CT SCAN, MRI, and Positron Emission Tomography (PET). Below are the main diagnostic categories that contribute significantly to the market depending on numerous factors such as the advancements in diagnostic technologies, and the prevalence of the disease healthcare infrastructure. Diagnostic categories are as follows.

  • Laboratory Testing
  • Imaging testing

Laboratory Testing: Tests conducted on samples of blood and urine in the laboratory show elevated levels of cortisol, aldosterone, and androgens—hormones generated by the adrenal glands.

  • Test for high cortisol

Dexamethasone treatment is used to detect high cortisol. Measuring ACTH levels in patients without adrenal tumors helps differentiate adrenal tumors from other high cortisol-causing disorders, while this medicine acts like cortisol to lower cortisol levels in those people.

For example, on 16th June 2020, the first medication that can preserve lives when used to treat coronavirus was dexamethasone.

  • Test for high aldosterone

If the tumor is making aldosterone the level of high aldosterone takes place and thus leads to low blood levels of potassium and renin

  • Test for high androgens and estrogen

Dehydroepiandrosterone sulfate (DHEAS), or testosterone, is present in high concentrations in patients with androgen-producing tumors. Blood levels of estrogen become increased in patients with tumors that produce estrogen.

Imaging testing

  • CT (Computed Tomography) Scan: CT scans are frequently used to see the adrenal glands and the structures around them. They provide precise cross-sectional images that are used to locate and detect malignancies.

Approximately 1 in 10 individuals who have an adrenal gland imaging test (such as a CT or MRI) have an adrenal tumor, the majority of which are benign adenomas.

  • MRI (Magnetic Resonance Imaging): Identification of adrenal tumors is easily detected with the help of MRI scans, which provide exquisitely detailed images of soft tissues.
  • PET (Positron Emission Tomography) Scan: PET scans help to differentiate between benign and malignant lesions by measuring the metabolic activity of adrenal tumors.

In a more recent study, 11C-metomidate (METO), a marker of 11β-hydroxylase, was used to perform PET for adrenocortical imaging. While results were mixed, METO PET was reported to have ~89% and ~96% sensitivity and specificity for identifying cancers of adrenocortical origin (n = 73).

  • Metaiodobenzylguanidine (MIBG) scan: MIBG is a substance that accumulates in neuroendocrine tumors and is comparable to adrenaline. An adrenal medulla tumor is detected using a MIBG scan. The scan happens over two days. An arm injection of MIBG is administered on the first day. A few hours later, images captured by a specialized camera reveal whether the MIBG has accumulated in the body.

MIBG scans show a 100% positive predictive value and good specificity. In twenty-one patients (42%), it confirms that pheochromocytoma is present. Ninety percent of neuroblastomas have MIBG uptake, which identifies the source tumor and the locations of metastatic illness.

Depending on the probable kind of adrenal gland cancer and the presentation of each patient, a different diagnostic strategy is used. Improved projections and efficient treatment planning are contingent upon an early and precise diagnosis for patients suffering from adrenal gland cancer.

Top Players of Diagnostic Kits

The global Adrenal carcinoma diagnostic market is highly competitive and owing to the number of large market players with a global presence below in the given table there is a list of top manufacturers of diagnostic testing of adrenal tumors globally.


Product Portfolio

Biolab Diagnostics India Pvt Ltd

Cancer Test Kits RAPID PAP

Biofix Spray CY1573

Aso Turbilatex Test Kit

Recombigen Laboratories Private Limited

Rapid Test Kit and Lab Accessories

Precision biomed Medical Diagnostic Kits


GE Healthcare

MRI Scan Machines

SIGNA™: Tomorrow Today

Siemens Healthineers


Philips Healthcare

MR 7700 3T MRI scanner

Hitachi Medical Systems

HyBEAT Heavy-ion Therapy System HyBEAT

Carestream Health

DR detectors

Tinomed Healthcare Private Limited

Siemens TRIO 3T MRI



PET/CT scanner BPT-48


PET/CT scanner ScintCare PET/CT 730T


PET/CT scanner NeuSight

Siemens Healthineers

0.55T MAGENTOM Free.Max 80 cm MR Scanner



(MR-Guided Radiotherapy)


Elekta Versa HD™

Digital accelerator for advanced image-guided radiation therapy (IGRT)


Treatment Analysis


The application of specific medication classes to treat cancer is known as chemotherapy, or "chemo." The medications are usually taken orally (as pills) or intravenously. This treatment is effective for cancer that has metastasized (spread to organs outside of the adrenal gland) because these medications enter the bloodstream and travel throughout the body. Since chemotherapy is a poor treatment for adrenal cancer, it is typically reserved for cases where the cancer has progressed too far to be surgically removed (albeit this does not guarantee a cure).

For instance, Mitotane is the drug most often used for people with adrenal cancer.

Mechanism of action - Mitotane is a medication that kills adrenal cancer cells and prevents the adrenal gland from producing hormones, leading to low cortisol levels and symptoms. It is used as adjuvant therapy after surgery to kill cells left behind and potentially prevent cancer return. It is particularly helpful for adrenal cancers with excessive hormone production.

The only systemic treatment for advanced-stage ACC that has received FDA approval is mitotane, a derivative of insecticide. Nevertheless, patients find it challenging due to toxicity and limited response rates. Patients with advanced ACC who are not surgical candidates should take mitotane in addition to platinum-based chemotherapy, according to the FIRM-ACT trial. Although the median survival is shorter, patients taking EDP-M (Etoposide, Doxorubicin, Mitotane, and Cisplatin) had a greater response rate.

Radiation therapy

High-energy X-rays or particles are used in radiation treatment to destroy cancer cells. As a primary treatment for adrenal cancer, radiation therapy is rarely performed because it is difficult to destroy the cancer cells with X-rays. Following surgery, radiation therapy is performed to help prevent the tumour from returning. We refer to this as adjuvant therapy. Additionally, radiation therapy can be utilized to address cancerous spread to organs including the brain or bones.

Types of radiation therapy

External beam radiation therapy

Radiation therapy using external beam technology targets cancer with radiation from an external machine without causing pain. It takes longer to set up and is comparable to x-rays. Prior to starting treatment, the radiation team performs measurements and imaging examinations.


IRT (internal radiation therapy) involves injecting tiny radioactive pellets into or adjacent to the malignancy, occasionally within tiny plastic tubes. After a few days, the pellet-containing tubes are taken out of the ground. The size of the tumor and the potency of the radioactive pellets dictate the real-time. Adrenal cortical cancer is not frequently treated with this kind of radiation.

Furthermore, to British Journal of Cancer, emphasizes the role of radiotherapy (RT) in the management of advanced adrenocortical carcinoma (ACC).

The study provides clear evidence that RT is effective in the treatment of ACC, with a focus on its efficacy and safety in advanced stages of the disease. Additionally, a review article in Frontiers in Endocrinology discusses the use of radiation therapy as one of the various additional therapies and strategies in the treatment of ACC.

On 17th Oct 2023, a Phase 1 radiopharmaceutical program against a novel target for adrenocortical carcinoma was initiated, highlighting the ongoing research and development efforts in this field.

Anticancer Drugs Used for Treatment

The below table shows the three Anticancer drugs used for the treatment of adrenal carcinoma currently with information on the mode of action, typical dosing, formulation, and side effects:



Mode of Action

Typical Dosing


Side Effects



Maintains microtubule stability and stops cancer cells from bifurcating into two distinct cells

Intravenously for three hours at a dose of 175 mg/m2, and then at a dose of 75 mg/m2 of cisplatin.


Sore mouth

Joint or muscle pain

Bruising and bleeding

Allergic reaction



Mitotane directly inhibits the adrenal cortex, affecting steroids peripheral metabolism, leading to increased 6-β-hydroxycortisol production and decreased 17 hydroxycorticosteroids without a decrease in corticosteroid concentrations.

2 to 6 grams (g) per day

given in 3 or 4 divided doses per day

Oral route

Darkening of the skin


dizziness or light-headedness


loss of appetite

mental depression



For the above drugs, the FDA has approved research in the United States Mitotane is the only FDA-approved chemotherapeutic medication for adrenocortical cancer (ACC). An adrenolytic substance called Mitotane is created from Dichlorodiphenyltrichloroethane, a pesticide. For many years, it has been an accepted course of treatment for advanced stage ACC.

Manufacturing of Anticancer Drugs

Manufacturer of Anti-Drug

Product/Brand Name

TherDose Pharma Private Limited.

 Lysodren®, Lisodren®

Manufacturers of anticancer medications get important insights and knowledge from DiseaseLandscape Insights. Thus, it helps them with focused research and development to conduct, information on CDMO, CMO, SMO, and raw material suppliers, along with legal compliance for the company in production process optimization. DiseaseLandscape Insights services also help in directing the target population identification, and marketing strategies, and keep market players updated with industry trends. Manufacturers are creating and deploying efficient treatments to stop and manage adrenal carcinoma outbreaks by utilizing data from Disease Landscape Insights.

Services Offered by DiseaseLandscape Insights in the Adrenal Gland Cancer Industry to grow exponentially.

Developing a community: Joint Ventures to Fight Nodule on the adrenal gland.

DiseaseLandscape Insights serves a purpose in directing and setting up commercial adrenal tumor cancer services to leading global players. It supports them by providing market analysis of product launch expansion, research & development in the field of drug discovery and launch phase, resource allocation, risk estimation on efficacy and safety of drugs, collaboration services among the supply chain, and long-term planning by providing insights into the dynamics of the disease. DiseaseLandscape Insight provides intensive services in data management to clinical and drug safety concerns, along with medical writing which involves writing scientific papers for a variety of objectives, like legislative and research-related documents, disease- or associated with drugs instructional and promotional materials, journal articles and abstracts for publications, and website content for the healthcare industry. In delivering regulatory issues, professionals respond to the expectations of market players within the Healthcare Industry.

The commercial aspect of adrenal gland tumor disease focuses on a range of services and products, from management and prevention to further treatment and research, which try to address the effects of the illness. Following are the services taken to initiate eliminating the outbreak.

Regulatory Framework for adrenal cortical cancer

‘’Resolving the Regulation Requirements for Adrenal Gland Cancer: A Comprehensive Approach ‘’

The regulatory framework for adrenal gland malignancy is heavily facilitated by Disease Landscape Insights based on different countries’ regulatory norms. It offers data-driven insights that direct risk assessment, regulatory development, surveillance, import/export laws, research oversight, response to emergency planning, and collaboration across borders. Institutes and market players can effectively prevent, control, and respond to outbreaks of adrenal carcinoma while making sure that the affected communities are safe and well-cared for by integrating DLI into the regulatory framework.

According to FDA Mitotane is the only FDA-approved systemic therapy in ACC. The insecticide Dichlorodiphenyltrichloroethane (DDT) is the source of this adrenolytic substance. For decades, patients with advanced-stage ACC have received mitotane as the conventional treatment to manage tumor progression and hypercortisolemia. However, the response rates are only about 30% and the systemic toxicities make it difficult for patients to tolerate due to a narrow therapeutic window.

 Competitive Analysis

"Releasing Industry Opportunities: Explore the suprarenal cancer Market's Competitive Landscape."

  • To satisfy the growing need for early detection and improve their competitive position, leading companies in the international market have been focusing on new product launches and expanding their testing capabilities In addition to that they are adopting organic and inorganic strategies for growth and expansion which majorly includes drug discovery regulatory approval and inorganic strategy such as acquisition partnership and majorly focusing on collaboration order to improve and grow their product portfolio.
  • For instance, On 10th Nov 2021 with the New VT-X750-V3 AXI System, OMRON introduces the fastest Ct X-Ray inspection in the world. OMRON has developed the world's fastest CT-type X-ray inspection device, the VT-X750-V3, which was released globally on November 20. This advanced 3D inspection is designed to meet the growing needs of fifth-generation mobile communication systems, electric vehicles, and autonomous driving applications.
  • However, on 6th July 2021, Siemens Healthineers announced that the Magnetom Free. Max, a revolutionary High-V magnetic resonance (MR) scanner that combines deep learning technology and powerful image processing with a 0.55 Tesla (0.55T) field strength, has received FDA certification in the United States.

Market Trends Analysis

‘Develop the changing patterns of the market in adrenal cortical carcinoma to be ahead of the curve’’.

Advances in medical imaging technology, including PET-CT and advanced MRI scans, have been significant in the diagnosis of adrenal tumors by providing accurate localization and characterization. Furthermore, improvements in genomic sequencing and molecular profiling have made it possible to comprehend the genetic alterations linked to adrenal carcinoma more thoroughly, which has aided in the creation of tailored treatments.

For Instance, on May 31, 2023, GE HealthCare's leadership position in artificial intelligence is strengthened with the FDA's approval of a new deep-learning solution for improved PET/CT image quality.

Furthermore, on November 22, 2023, the Biograph Vision. X a positron emission tomography/computed tomography (PET/CT) scanner from Siemens Healthineers has received FDA clearance in the United States. Its time of flight (TOF) is 178 picoseconds (ps), which is the fastest TOF in the industry. The performance of the Biograph Vision scanner series is built upon the next-generation system.

Clinical Assessment

Here the exciting journey into the world of adrenocortical tumors gets underway in Disease Landscape, where novel advancements and exceptional revolutionary possibilities transform the disease landscape.

Establishing and carrying out clinical trials for novel treatments and medications, patient recruitment strategies, regulatory compliance, ensuring positive trial outcomes, etc. are all made easier with the assistance of Disease Landscape. The study titles of the currently ongoing clinical trials, together with the phases in which they are currently being done, are provided in the table below.


(Therapeutic Exploratory Trail)


(Therapeutic Confirmatory Trial)

A Phase II Study to Evaluate the Efficacy and Safety of Pembrolizumab in Combination with Mitotane in Patients with Advanced Adrenocortical Carcinoma

A Randomized Registry Trial of Adjuvant Mitotane vs. Mitotane with Cisplatin/Etoposide After Primary Surgical Resection of Localized Adrenocortical Carcinoma with High Risk of Recurrence (ADIUVO-2 Trial)

Prospective, Phase II Study to Evaluate the Efficacy of Addition of Progesterone to Standard Chemotherapy According to Etoposide-Doxorubicin-Cisplatin Scheme Plus Mitotane (EDP-M) in Patients with Advanced Adrenocortical Carcinoma (ACC)


The Adrenal Gland Cancer diseases market has some challenges and DiseaseLandscape Insights supports in providing solutions to the challenges faced by a market player in the Adrenal carcinoma industry.

There are different market scenarios concerning countries/regions for adrenal cortex cancer-specific diagnostics and medications. Owing to the disease's modest impact & the challenges associated with commercial viability to treat diseases, different national investments in adrenal cortical cancer-specific treatments.

DLI aids in identifying the target market, driving strategic business plans, and keeping market participants informed of emerging trends. Disease Landscape insights services help manufacturers in developing and implementing effective medicines to halt and control adrenal cortical cancer outbreaks.

In addition, there is greater demand for diagnostic devices, clinical assessment, and Adrenal Carcinoma chemotherapy drugs because of expanding awareness and expected outbreaks. DLI experts provide crucial services across the business segment and the assistance provided makes it simpler to establish and conduct clinical trials for novel therapies and pharmaceuticals, patient recruitment tactics, regulatory compliance, assuring favorable trial outcomes, etc.

This supports companies in performing focused research and development, learning about contract manufacturing organizations and SMOs, finding raw material suppliers, and ensuring legal compliance for the business benefit.

DiseaseLandscape Insights (DLI) supports all market players in establishing their greater foothold in the Adrenal Carcinoma disease industry.

Vishal SawantBusiness Development

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