ICPACT is a collaborative platform that aims to integrate ACT researchers and institutions to advance pediatric ACT research.

The initiative led by Bonald C. Figueiredo (Pequeno Principe Hospital and Research Institute, Curitiba, Brazil), is focused on mapping new members who are dedicated to integrating pediatric ACT research, securing funding for a structured ICPACT website, periodical Workshops hosted by each member and organizing multi-institutional projects.

Under new leadership by Camila Daiggi (starting in November 2024) the goals include launching "The Stage II Project" at the Boldrini Research Center (Campinas – SP, Brazil), implementing the REDCap Boldrini system, convening all ACT researchers and families in an international workshop at the Boldrini Center in November 2024 sponsored by CNRS-IPMC (PI Enzo Lalli), and empowering members to coordinate in different departments (pre-clinical research, clinics, genetics, pathology, epidemiology, etc).

Another objective of ICPACT is to improve the guidelines on the Metabolism of Mitotane

Metabolomics of mitotane: metabolites levels that may predict clinical outcome using 2D Chromatography

Because of restrictive regulations by ANVISA (the Brazilian “FDA”) it is extremely difficult to receive frozen samples from foreign countries, and we prefer to receive plasma or serum only from Brazilian Institutions

There is widespread agreement that the management of ACC patients with persistent or recurrent disease could be benefited by better control of mitotane treatment, specially regarding metabolomics, which includes uncertainties in the therapeutic window (including mitotane and its NOT YET PROPERLY EXAMINED 3 main metabolites, 2 DDA and 1 DDE).

Here the consortium may be benefited with unlimited number of tests of ACT patient samples to be analyzed by Dr. Lauro M. Souza (Pequeno Príncipe Research Institute), and frozen serum samples may be sent and communicated directly to his Whatsapp (+55 41 99229 0618). The idea is to define levels and outcome according to timing, age, dose, steroid levels, persistent microscopic/macroscopic lesion, etc).

Participants will be coauthors of this future article (next 18 months):


Simple Mitotane TDM (Therapeutic Drug Monitoring over the time)

    Two opposite profiles:

    (a) Subtherapeutic in patient 1, despite increased daily dose;

    (b) Supratherapeutic (toxic) in patient 2, despite decreased daily dose.

    We believe that these differences need to be investigated together with all metabolites using 2D chromatography

    Two metabolic profiles in R1 children

    Preliminary data (Stadler et al., 2023) to illustrate the need for future studies associated with outcome and side effects

    Plasma from R1 and R2 pACT patients on mitotane

    Sample Analysis Form

    This is a Research Project, entitled “investigation of mitotane and its metabolites in sera/plasma of ACT patients”, approved by the Hospital Pequeno Príncipe Ethics Committee (EC). If you decide to request analyses for your patients you will need previous approval from your Institution’s EC (or IRB).

    Reported results/sample: mitotane (R & S), o,p’-DDA (R & S) and o,p’-DDE

    Method: Liquid Chromatography
    Preferential sample and volume: at least 1 mL of plasma in heparinized tubes sent in dry ice (if you are in another country) or in gel pack (if you are in Brazil) to:

    Instituto de Pesquisa Pelé Pequeno Príncipe
    Av. Munhoz da Rocha, no. 490
    Bairro Cabral, Curitiba-PR
    CEP: 80035-000

    Chromatography Laboratory
    Dr. Lauro M. Souza and Alan A. Veiga
    Considering that transport is expensive, you may accumulate samples and send later to Curitiba.


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