Options mapped

Adrenocortical carcinoma: options by country

Sourced options by country plus visit-prep questions for Adrenocortical carcinoma. Each line links to its regulator, HTA, or guideline source. This page maps options; it does not recommend or rank them.

Options mappedSolid tumorLast checked June 2026

What this page does

Maps options by country

It maps sourced options by country alongside diagnosis wording, stage, test results, specialists, and trial-search terms.

What it does not do

Does not choose treatment

It does not rank treatments, recommend a choice, or decide clinical fit.

Where it comes from

Built on trusted sources

Every option links to a trusted regulator, HTA, or guideline source, and the list grows as new sources pass verification.

Information to gather before the next visit

Is complete surgical resection feasible at an ACC-experienced center?
Is mitotane being discussed as adjuvant, unresectable, metastatic, or symptom-control therapy?
Are hormone-producing symptoms being managed alongside cancer-directed treatment?
Is the ACC inoperable, functional, or nonfunctional under the U.S. label indication?

Trial-search terms to discuss

Adrenocortical carcinoma clinical trial

Options by country

Treatments by country

Regulatory and access status by country, from official sources. It shows what exists and where — not a recommendation.

United States

Mitotane (Lysodren)[1]FDA-approvedFunctional versus nonfunctional hormonal status is clinically relevant; no genomic biomarker required by fetched U.S. label; Inoperable functional or nonfunctional ACC. · Label indication does not establish payer coverage, treatment suitability, or dosing for a specific patient. Label includes major safety updates and monitoring/handling precautions. Confidence/conflicts: High for U.S. labeled indication.
Mitotane (Lysodren)[1]FDA-approvedFunctional versus nonfunctional hormonal status is clinically relevant; no genomic biomarker required by fetched U.S. label; Inoperable functional or nonfunctional ACC. · Label indication does not establish payer coverage, treatment suitability, or dosing for a specific patient. Label includes major safety updates and monitoring/handling precautions. Confidence/conflicts: High for U.S. labeled indication.

European Union

Mitotane (Lysodren)[2]EMA authorisedFunctional hormone-producing status affects symptom benefit; no genomic biomarker required by fetched EMA source; Advanced unresectable, metastatic, or relapsed ACC; symptom treatment context per EMA wording. · EMA central authorisation does not establish member-state reimbursement, local specialist access, or individual eligibility. EMA notes limited evidence for some uses and the need for blood-level monitoring. Confidence/conflicts: High for EU authorised indication; national reimbursement remains unverified.
Mitotane (Lysodren)[2]EMA authorisedFunctional hormone-producing status affects symptom benefit; no genomic biomarker required by fetched EMA source; Advanced unresectable, metastatic, or relapsed ACC; symptom treatment context per EMA wording. · EMA central authorisation does not establish member-state reimbursement, local specialist access, or individual eligibility. EMA notes limited evidence for some uses and the need for blood-level monitoring. Confidence/conflicts: High for EU authorised indication; national reimbursement remains unverified.
Mitotane (Lysodren)[2]EMA authorisedFunctional hormone-producing status affects symptom benefit; no genomic biomarker required by fetched EMA source; Advanced unresectable, metastatic, or relapsed ACC; symptom treatment context per EMA wording. · EMA central authorisation does not establish member-state reimbursement, local specialist access, or individual eligibility. EMA notes limited evidence for some uses and the need for blood-level monitoring. Confidence/conflicts: High for EU authorised indication; national reimbursement remains unverified.

United Kingdom

Mitotane (Lysodren), alone or with other chemotherapy drugs [3]ApprovedNo biomarker required by fetched UK source; Unresectable, relapsed, or metastatic ACC. · Cancer Research UK is a patient/professional cancer information charity, not MHRA/NICE. Exact UK licensing, commissioning, and local formulary status require separate regulator/NHS source verification. Confidence/conflicts: Medium-high for UK treatment-information context; exact MHRA/NICE status remains an active gap.
Mitotane (Lysodren), alone or with other chemotherapy drugs [3]ApprovedNo biomarker required by fetched UK source; Unresectable, relapsed, or metastatic ACC. · Cancer Research UK is a patient/professional cancer information charity, not MHRA/NICE. Exact UK licensing, commissioning, and local formulary status require separate regulator/NHS source verification. Confidence/conflicts: Medium-high for UK treatment-information context; exact MHRA/NICE status remains an active gap.

Sources

DailyMed / U.S. FDA label — official drug label · official drug label
European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
Cancer Research UK — UK cancer information / drug information · UK cancer information / drug information

This is official regulatory and access status only — not medical advice, not a recommendation, and not a statement about eligibility. Whether any option fits depends on your situation and your oncology team. Status changes over time; confirm the current position with the linked source. Last checked 2026-06-12.

Beyond approved care

In clinical trials & emerging options

Options that are not — or not yet — an approved standard where you live: studies, clinical trials, off-label use, and early evidence that your own oncologist may not raise. Each is labeled by how strong the evidence is. A listing here is information to research and discuss with your team; it does not mean a treatment is proven, safe for you, or available today.

In clinical trials

Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
Complete surgical removal; adjuvant mitotane under clinical evaluation; radiation therapy for selected unresectable/localized or metastatic sites; mitotane; mitotane plus streptozotocin or mitotane plus etoposide/doxorubicin/cisplatin; antisteroidogenic drugs for hormone excess; clinical trialsClinical trialClinical trialInvestigationalUnited States · No biomarker required by fetched NCI PDQ source; Stage I-II localized ACC, stage III locally advanced ACC, stage IV metastatic ACC, recurrent ACC, hormone-producing ACC symptom control. · NCI PDQ is an evidence summary and not a formal guideline, payer, or regulator source. Adjuvant mitotane and several radiation/systemic approaches are described as under clinical evaluation. Confidence/conflicts: High for U.S. evidence-summary framework; regulator-specific mitotane indication recorded separately. National Cancer Institute (NCI) — national cancer agency evidence summary
OsilodrostatClinical trial · NCT02468193Clinical trialTrial only (registry)Japan · Hormone-producing Cushing syndrome context; no genomic biomarker required by fetched registry record; Cushing syndrome and related adrenal disease context including adrenal carcinoma. · This is not an ACC-directed anticancer trial; it is a hormonal/symptom-control context that includes adrenal carcinoma. Registry listing does not establish PMDA approval, reimbursement, routine access, or individual eligibility. Confidence/conflicts: Medium for Japan ACC-related supportive/hormonal trial context; low for Japan tumor-directed ACC treatment availability. ClinicalTrials.gov — clinical-trial registry
OsilodrostatClinical trial · NCT02468193Clinical trialTrial only (registry)Japan · Hormone-producing Cushing syndrome context; no genomic biomarker required by fetched registry record; Cushing syndrome and related adrenal disease context including adrenal carcinoma. · This is not an ACC-directed anticancer trial; it is a hormonal/symptom-control context that includes adrenal carcinoma. Registry listing does not establish PMDA approval, reimbursement, routine access, or individual eligibility. Confidence/conflicts: Medium for Japan ACC-related supportive/hormonal trial context; low for Japan tumor-directed ACC treatment availability. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab plus lenvatinib; real-world adrenal disease registry/cohort management studiesClinical trial · NCT05036434Clinical trialTrial only (registry)Korea · No biomarker required by fetched Korea registry records; Advanced adrenal cortical carcinoma for pembrolizumab/lenvatinib; adrenal disease evidence-generation/cohort contexts including ACC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Observational adrenal disease records are not treatment access records. Confidence/conflicts: Medium-high for Korea registry-listed ACC trial/cohort activity; routine access unverified. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab plus lenvatinib; real-world adrenal disease registry/cohort management studiesClinical trial · NCT05036434Clinical trialTrial only (registry)Korea · No biomarker required by fetched Korea registry records; Advanced adrenal cortical carcinoma for pembrolizumab/lenvatinib; adrenal disease evidence-generation/cohort contexts including ACC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Observational adrenal disease records are not treatment access records. Confidence/conflicts: Medium-high for Korea registry-listed ACC trial/cohort activity; routine access unverified. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab plus lenvatinib; real-world adrenal disease registry/cohort management studiesClinical trial · NCT05036434Clinical trialTrial only (registry)Korea · No biomarker required by fetched Korea registry records; Advanced adrenal cortical carcinoma for pembrolizumab/lenvatinib; adrenal disease evidence-generation/cohort contexts including ACC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Observational adrenal disease records are not treatment access records. Confidence/conflicts: Medium-high for Korea registry-listed ACC trial/cohort activity; routine access unverified. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab plus lenvatinib; real-world adrenal disease registry/cohort management studiesClinical trial · NCT05036434Clinical trialTrial only (registry)Korea · No biomarker required by fetched Korea registry records; Advanced adrenal cortical carcinoma for pembrolizumab/lenvatinib; adrenal disease evidence-generation/cohort contexts including ACC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Observational adrenal disease records are not treatment access records. Confidence/conflicts: Medium-high for Korea registry-listed ACC trial/cohort activity; routine access unverified. ClinicalTrials.gov — clinical-trial registry
Camrelizumab plus apatinib plus mitotane; adjuvant radiotherapy versus observation; camrelizumab plus apatinib second-line; individualized mRNA neoantigen vaccine (mRNA-0523-L001); triprolizumab plus radiotherapy; China adrenal disease registryClinical trial · NCT06831175Clinical trialTrial only (registry)China · Individualized mRNA neoantigen vaccine study implies tumor-specific neoantigen selection; no other biomarker required by fetched China registry records; Advanced ACC; high-risk localized ACC after surgery; recurrent/metastatic ACC; advanced endocrine tumor including ACC. · Registry records do not establish NMPA approval, reimbursement, routine access, active enrollment for all studies, or individual eligibility. Some records are registry or not-yet-recruiting rather than treatment access. Confidence/conflicts: High for China registry-listed ACC trial activity; local approval/access status unverified. ClinicalTrials.gov — clinical-trial registry
Camrelizumab plus apatinib plus mitotane; adjuvant radiotherapy versus observation; camrelizumab plus apatinib second-line; individualized mRNA neoantigen vaccine (mRNA-0523-L001); triprolizumab plus radiotherapy; China adrenal disease registryClinical trial · NCT06831175Clinical trialTrial only (registry)China · Individualized mRNA neoantigen vaccine study implies tumor-specific neoantigen selection; no other biomarker required by fetched China registry records; Advanced ACC; high-risk localized ACC after surgery; recurrent/metastatic ACC; advanced endocrine tumor including ACC. · Registry records do not establish NMPA approval, reimbursement, routine access, active enrollment for all studies, or individual eligibility. Some records are registry or not-yet-recruiting rather than treatment access. Confidence/conflicts: High for China registry-listed ACC trial activity; local approval/access status unverified. ClinicalTrials.gov — clinical-trial registry
Camrelizumab plus apatinib plus mitotane; adjuvant radiotherapy versus observation; camrelizumab plus apatinib second-line; individualized mRNA neoantigen vaccine (mRNA-0523-L001); triprolizumab plus radiotherapy; China adrenal disease registryClinical trial · NCT06831175Clinical trialTrial only (registry)China · Individualized mRNA neoantigen vaccine study implies tumor-specific neoantigen selection; no other biomarker required by fetched China registry records; Advanced ACC; high-risk localized ACC after surgery; recurrent/metastatic ACC; advanced endocrine tumor including ACC. · Registry records do not establish NMPA approval, reimbursement, routine access, active enrollment for all studies, or individual eligibility. Some records are registry or not-yet-recruiting rather than treatment access. Confidence/conflicts: High for China registry-listed ACC trial activity; local approval/access status unverified. ClinicalTrials.gov — clinical-trial registry
Camrelizumab plus apatinib plus mitotane; adjuvant radiotherapy versus observation; camrelizumab plus apatinib second-line; individualized mRNA neoantigen vaccine (mRNA-0523-L001); triprolizumab plus radiotherapy; China adrenal disease registryClinical trial · NCT06831175Clinical trialTrial only (registry)China · Individualized mRNA neoantigen vaccine study implies tumor-specific neoantigen selection; no other biomarker required by fetched China registry records; Advanced ACC; high-risk localized ACC after surgery; recurrent/metastatic ACC; advanced endocrine tumor including ACC. · Registry records do not establish NMPA approval, reimbursement, routine access, active enrollment for all studies, or individual eligibility. Some records are registry or not-yet-recruiting rather than treatment access. Confidence/conflicts: High for China registry-listed ACC trial activity; local approval/access status unverified. ClinicalTrials.gov — clinical-trial registry
Camrelizumab plus apatinib plus mitotane; adjuvant radiotherapy versus observation; camrelizumab plus apatinib second-line; individualized mRNA neoantigen vaccine (mRNA-0523-L001); triprolizumab plus radiotherapy; China adrenal disease registryClinical trial · NCT06831175Clinical trialTrial only (registry)China · Individualized mRNA neoantigen vaccine study implies tumor-specific neoantigen selection; no other biomarker required by fetched China registry records; Advanced ACC; high-risk localized ACC after surgery; recurrent/metastatic ACC; advanced endocrine tumor including ACC. · Registry records do not establish NMPA approval, reimbursement, routine access, active enrollment for all studies, or individual eligibility. Some records are registry or not-yet-recruiting rather than treatment access. Confidence/conflicts: High for China registry-listed ACC trial activity; local approval/access status unverified. ClinicalTrials.gov — clinical-trial registry

A clinical-trial listing or early report shows an option is being studied — not that it works, that it is safe for any one person, or that a site is enrolling today. Whether any of these fits is a conversation for your oncology team and the trial team. Last checked 2026-06-12.