Senda Masaya, Hashimoto Kohei, Shindo Tetsuya, Kobayashi Ko, Tanaka Toshiaki, Masumori Naoya
Department of Urology Sapporo Medical University School of Medicine Sapporo Japan.
IJU Case Rep. 2023 Sep 21;6(6):382-385. doi: 10.1002/iju5.12628. eCollection 2023 Nov.
Advanced adrenocortical carcinoma has a poor prognosis and is treated with chemotherapy that includes mitotane with etoposide, doxorubicin, and cisplatin as first-line therapy. However, second-line therapy has not been determined yet. Pembrolizumab has been approved for high microsatellite instability for which standard treatments have failed.
Here, we present a patient with advanced adrenocortical carcinoma treated with complete surgical resection. 21 months later, he had local and metastatic recurrences. After four cycles of first-line therapy, we switched to pembrolizumab because microsatellite instability-high was detected in his tumor. He has received mitotane and pembrolizumab for 15 months, and this has exerted a radiographical response without severe adverse events.
We presented a patient with microsatellite instability-high advanced adrenocortical carcinoma treated with pembrolizumab and mitotane.
晚期肾上腺皮质癌预后较差，其化疗方案包括以米托坦联合依托泊苷、多柔比星和顺铂作为一线治疗。然而，二线治疗方案尚未确定。帕博利珠单抗已被批准用于标准治疗失败的高度微卫星不稳定情况。
在此，我们报告一名接受了完整手术切除的晚期肾上腺皮质癌患者。21个月后，他出现局部和远处复发。在进行了四个周期的一线治疗后，由于在其肿瘤中检测到高度微卫星不稳定，我们改用了帕博利珠单抗。他接受米托坦和帕博利珠单抗治疗15个月，出现了影像学反应且无严重不良事件。
我们报告了一名接受帕博利珠单抗和米托坦治疗的高度微卫星不稳定晚期肾上腺皮质癌患者。
