Onco Wiki / Regimen

EDP-M (etoposide + doxorubicin + cisplatin + mitotane) — FIRM-ACT regimen

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

ComponentsDRUG-ETOPOSIDE DRUG-DOXORUBICIN DRUG-CISPLATIN DRUG-MITOTANE
IDREG-EDP-M-ACC
TypeRegimen
Statusreviewed 2026-07-11 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-ENSAT-ACC-2018 SRC-ESMO-ACC-2020 SRC-FIRM-ACT-FASSNACHT-2012

Notes

STUB pending clinical co-lead sign-off (CHARTER §6.1). Regimen doses and schedule (etoposide 100 mg/m² days 2-4, doxorubicin 40 mg/m² day 1, cisplatin 40 mg/m²/day days 3-4, every 28 days, plus continuous mitotane targeting 14-20 mg/L) reproduced from the FIRM-ACT trial (Fassnacht 2012 NEJM) as corroborated by secondary search sources this session; verify against the primary NEJM publication before clinical use. FIRM-ACT results: response rate 23.2% (EDP-M) vs 9.2% (streptozocin+mitotane), p<0.001; median PFS 5.0 vs 2.1 months; median OS 14.8 vs 12.0 months (p=0.07, not significant — confounded by permitted crossover at progression). EDP-M is the preferred 1L combination based on the response/PFS advantage. Per the disease-level "mitotane +/- EDP" narrative, mitotane monotherapy alone (without full EDP) remains a reasonable alternative for patients unfit for combination cytotoxic chemotherapy or with more indolent/lower-burden disease — not separately authored as a distinct Regimen/Indication in this KB pass (see ALGO-ACC-1L step 3 null-branch notes).

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