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May 1985

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

Author Affiliations

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

Arch Intern Med. 1985;145(5):863-864. doi:10.1001/archinte.1985.00360050119020

• 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)