Ketoconazole. Use in the treatment of ectopic adrenocorticotropic hormone production and Cushing's syndrome in small-cell lung cancer

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Abstract
Ketoconazole, an imidazole derivative with antifungal properties, was shown to inhibit ACTH and androgen production. A patient with small-cell lung cancer and Cushing''s syndrome secondary to ectopic secretion of ACTH in whom it was necessary to discontinue chemotherapy was treated. 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.