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Use in the Treatment of Ectopic Adrenocorticotropic Hormone Production and Cushing's Syndrome in Small-Cell Lung Cancer

Frances A. Shepherd, MD, FRCP(C); Blake Hoffert, MD; William K. Evans, MD, FRCP(C); Guy Emery, MD, FRCP(C); John Trachtenberg, MD, FRCS(C)

Arch Intern Med. 1985;145(5):863-864.

Abstract
• Recently, ketoconazole, an imidazole derivative with antifungal properties, has been shown to inhibit adrenal corticosteroid and androgen production. We treated a patient with small-cell lung cancer and Cushing's syndrome secondary to ectopic secretion of adrenocorticotropic hormone in whom it was necessary to discontinue chemotherapy. The patient was treated with ketoconazole, with a resultant reduction in urinary free cortisol and ketosteroid excretion and improvement in electrolyte balance. Ketoconazole may be a useful adjunct in the treatment of small-cell lung cancer or other malignancies associated with excessive corticosteroid production or as a hormonal therapy in breast or prostatic cancer.

(Arch Intern Med 1985;145:863-864)

Author Affiliations
From the Departments of Medicine (Drs Shepherd, Hoffert, Evans, and Emery) and Surgery (Dr Trachtenberg), Toronto General Hospital.

Footnotes
Accepted for publication Aug 30, 1984.

Reprint requests to Toronto General Hospital, 101 College St, ML1-053, Toronto, Ontario, Canada M5G 9Z9 (Dr Shepherd).

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