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Medical Approaches in Adrenocortical Carcinoma

The Role of Immunotherapy in the Treatment of Adrenocortical Carcinoma

Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
Author to whom correspondence should be addressed.
Biomedicines 2021, 9(2), 98;
Received: 25 November 2020 / Revised: 30 December 2020 / Accepted: 18 January 2021 / Published: 20 January 2021
Adrenocortical carcinoma (ACC) is a rare epithelial neoplasm, with a high tendency for local invasion and distant metastases, with limited treatment options. Surgical treatment is the method of choice. For decades, the mainstay of pharmacological treatment has been the adrenolytic drug mitotane, in combination with chemotherapy. Immunotherapy is the latest revolution in cancer therapy, however preliminary data with single immune checkpoint inhibitors showed a modest activity in ACC patients. The anti-neoplastic activity of immune checkpoint inhibitors such as anti-cytotoxic-T-lymphocyte-associated-antigen 4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1), and anti-PD-ligand-1 (PD-L1) antibodies in different solid tumors has aroused interest to explore the potential therapeutic effect in ACC as well. Multiple ongoing clinical trials are currently evaluating the role of immune checkpoint inhibitors in ACC (pembrolizumab, combination pembrolizumab and relacorilant, nivolumab, combination nivolumab and ipilimumab). The primary and acquired resistance to immunotherapy continue to counter treatment efficacy. Therefore, attempts are made to combine therapy: anti-PD-1 antibody and anti-CTLA-4 antibody, anti-PD-1 antibody and antagonist of the glucocorticoid receptor. The inhibitors of immune checkpoints would benefit patients with antitumor immunity activated by radiotherapy. Immunotherapy is well tolerated by patients; the most frequently observed side effects are mild. The most common adverse effects of immunotherapy are skin and gastrointestinal disorders. The most common endocrinopathy during anti-CTLA treatment is pituitary inflammation and thyroid disorders. View Full-Text
Keywords: adrenocortical cancer; immunotherapy; immune checkpoint inhibitors adrenocortical cancer; immunotherapy; immune checkpoint inhibitors
MDPI and ACS Style

Karwacka, I.; Obołończyk, Ł.; Kaniuka-Jakubowska, S.; Sworczak, K. The Role of Immunotherapy in the Treatment of Adrenocortical Carcinoma. Biomedicines 2021, 9, 98.

AMA Style

Karwacka I, Obołończyk Ł, Kaniuka-Jakubowska S, Sworczak K. The Role of Immunotherapy in the Treatment of Adrenocortical Carcinoma. Biomedicines. 2021; 9(2):98.

Chicago/Turabian Style

Karwacka, Izabela, Łukasz Obołończyk, Sonia Kaniuka-Jakubowska, and Krzysztof Sworczak. 2021. "The Role of Immunotherapy in the Treatment of Adrenocortical Carcinoma" Biomedicines 9, no. 2: 98.

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