Alam Walid, Bouferraa Youssef, Haibe Yolla, Shamseddine Ali
Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Clin Med Insights Oncol. 2021 Apr 8;15:11795549211007682. doi: 10.1177/11795549211007682. eCollection 2021.
Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis. Treatment options for ACC are limited, with resection the main intervention. Most cases present in late metastatic cases, and data regarding effective therapies is limited. We report a case of ACC in a 40-year-old woman with history of ACC postadrenalectomy, who presented with recurrent metastatic ACC in the left perinephric space. She was started on pembrolizumab which was added to her mitotane maintenance therapy. Complete radiological response was achieved after 4 cycles of pembrolizumab. As far as we know, this is the first case to achieve complete radiological response with mitotane and pembrolizumab in recurrent metastatic ACC, with negative prognostic markers and no prior radiotherapy. As our findings are in the setting of one clinical case, we suggest the need to perform a trial to assess the benefit of combining mitotane and pembrolizumab in treating metastatic ACC.
肾上腺皮质癌（ACC）是一种预后较差的罕见恶性肿瘤。ACC的治疗选择有限，主要干预手段是手术切除。大多数病例在晚期出现转移，关于有效治疗的数据有限。我们报告一例40岁女性ACC患者，有肾上腺切除术后ACC病史，此次出现左肾周间隙复发性转移性ACC。她开始接受帕博利珠单抗治疗，并将其添加到米托坦维持治疗中。帕博利珠单抗4个周期后实现了完全影像学缓解。据我们所知，这是第一例在复发性转移性ACC中使用米托坦和帕博利珠单抗实现完全影像学缓解的病例，该病例具有不良预后标志物且未接受过放疗。由于我们的研究结果基于一个临床病例，我们建议有必要进行一项试验，以评估联合使用米托坦和帕博利珠单抗治疗转移性ACC的益处。
