EDP-M (etoposide + doxorubicin + cisplatin + mitotane) — FIRM-ACT regimen
Visão determinística da entidade fonte YAML. A autoridade clínica permanece com os IDs de fonte citados e estado de assinatura do revisor.
Registro de base de conhecimento para auditoria. Conteúdo clínico provisório: não é uma prescrição. Um oncologista deve verificar fontes originais, aplicabilidade e estado de revisão. Regras completas e restrições estão no YAML.
| Componentes | DRUG-ETOPOSIDE DRUG-DOXORUBICIN DRUG-CISPLATIN DRUG-MITOTANE |
|---|
| ID | REG-EDP-M-ACC |
|---|---|
| Tipo | Esquema terapêutico |
| Estado | reviewed 2026-07-11 | pending_clinical_signoff |
| Doenças | Nenhuma declaração |
| Fontes | SRC-ENSAT-ACC-2018 SRC-ESMO-ACC-2020 SRC-FIRM-ACT-FASSNACHT-2012 |
Notas
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).
Usado por
Indicação
IND-ACC-1L-MITOTANE-EDP- IND-ACC-1L-MITOTANE-EDP