Outcome of immunotherapy in adrenocortical carcinoma: a retrospective cohort study
Authors' conclusion
In the real-life setting, we observe a response comparable to other second-line therapies and an acceptable safety profile in ACC patients receiving different ICI. The relevance of PD-L1 as a marker of response and the potentially more favourable outcome in nivolumab-treated patients require confirmation.
Study context
- Population
- Patients with advanced adrenocortical carcinoma (ACC) receiving immune checkpoint inhibitors (ICI) as compassionate use at 6 German reference centres, 2016–202252 survived ≥4 weeks
- Participants
- 54 patients
- Outcome
- Treatment response and survival with ICI
Methodological detailsmulticentre, real-life setting, compassionate use
- Multicentre
- Real-life setting
- Compassionate use
Main finding
As reported in the abstract
Objective response rate (ORR) (patients surviving ≥4 weeks)
13.5%
6–26
Disease control rate (DCR) (patients surviving ≥4 weeks)
24%
16–41
Progression-free survival (PFS)
3.0 months
95% CI 2.3–3.7
Median overall survival (OS) (all patients)
10.4 months
3.8–17
Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value | |
|---|---|---|---|---|
| PFS by occurrence of TRAETRAEvs No TRAE | TRAE 5.5 (interval 1.9–9.2) months · No TRAE 2.5 (interval 2.0–3.0) months | HR 0.29 (95% CI 0.13–0.66) | P = 0.001 | |
| OS by occurrence of TRAETRAEvs No TRAE | TRAE 28.2 (interval 9.5–46.8) months · No TRAE 7.0 (interval 4.1–10.2) months | HR 0.34 (95% CI 0.12–0.93) | ||
| Progression and death: nivolumab vs pembrolizumabNivolumabvs PembrolizumabAdjusted for concomitant mitotane use | HR (progression) 0.36 (CI 0.15–0.90) | |||
| Progression and death: nivolumab vs pembrolizumabNivolumabvs PembrolizumabAdjusted for concomitant mitotane use | HR (death) 0.20 (CI 0.06–0.72) | |||
| 0.050.21520Ratio (log scale) |
| Outcome | Values | P value |
|---|---|---|
| PFS by PD-L1 tissue stainingPD-L1 positive vs PD-L1 negative · longer PFS with positive staining | PD-L1 positive 3.2 (interval 2.6–3.8) months · PD-L1 negative 2.3 (interval 1.6–3.0) months | P < 0.05 |
Safety
- Treatment-related adverse events (TRAE) occurred
- 17 TRAE in 15 patients
Original publication
Outcome of immunotherapy in adrenocortical carcinoma: a retrospective cohort study. Eur J Endocrinol. Published 1 June 2023. doi:10.
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