EYES2022 ESE Young Endocrinologists and Scientists (EYES) 2022 Endocrine-related Cancer (11 abstracts)
Outcome of immuncheckpoint inhibitor therapy in adrenocortical carcinoma – A multicenter retrospective study
Remde H 1 , Schmidt-Pennington L 2 , Reuter M 1 , Landwehr L 1 , Jensen M 2 , Lahner H 3 , Laubner K 4 , Schreiner J 5 , Bojunga J 6 , Kircher S 7 , Pohrt A 8 , Teleanu M. V. 9 , Hübschmann D 9 , Stenzinger A 10 , Glimm H 11 , Fröhling S 9 , Fassnacht M 1 , Mai K 2 & Kroiss M. & 5
1University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetes; 2Charité - Universitätsmedizin Berlin, Department of Endocrinology & Metabolism; 3University Hospitals Duisburg-Essen, Department of Endocrinology and Metabolism; 4Medical Center-University of Freiburg, Division of Endocrinology and Diabetology, Department of Medicine II; 5University Hospital Munich, Ludwig-Maximilians-University München, Department of Internal Medicine IV; 6Goethe University Frankfurt Faculty 16 Medicine, Department of Internal Medicine 1, Division of Endocrinology; 7University of Würzburg, Institute of Pathology; 8 Charité-Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology; 9 Deutsches Krebsforschungszentrum, National Center for Tumor Diseases (NCT); 10 Universitätsklinikum Heidelberg, Institut für Pathologie; 11 National Center for Tumor Diseases (NCT), National Center for Tumor Diseases (NCT)
Background: Adrenocortical carcinoma is a rare endocrine malignancy with poor prognosis and few treatment options in advanced disease. Immune checkpoint inhibitors (ICI) have been studied in few clinical trials with a limited number of patients in ACC. No real-life data are available so far. In the present study we aimed at evaluating treatment response and safety of ICI treatment in advanced ACC and identifying clinical, biochemical, histological and molecular markers for prediction of treatment response
Methods: Retrospective cohort study of 54 patients with advanced ACC who received ICI outside of clinical trials at six German reference centers between 2016 and 2022. Progression-free (PFS) survival was the primary endpoint, secondary end points were overall survival (OS), objective response rate, and treatment-related adverse events (TRAE).
Results: In 52 patients surviving at least 4 weeks after initiation of ICI, median time to progression was 2.5 months (range 0.2-18) and median overall survival was 4.8 months (range 0.2-56). Objective response rate was 13.5% (CI 6-26) and disease control rate 24% (CI 16-41). 17 TRAE occurred in 15 patients (28 %) including seven grade III TRAE. The occurrence of an adverse event was associated with a significantly longer PFS (5.5 (CI 1.9-9.2) vs. 2.5 (CI 2.0- 3.0 months, P = 0.001; Hazard Ratio 0.29 (CI 0.13-0.66)) and OS (28.2 (CI 9.5-46.8) vs. 7 (CI 4.1-10.2) months, P < 0.05; Hazard Ratio 0.34 (CI 0.12-0.93)). No significant difference regarding PFS and OS was observed relative to concomitant mitotane treatment, glucocorticoid excess, other histological markers, and TMB.
Conclusions: We demonstrate limited efficacy comparable to other frequently used second line therapies and acceptable safety profile of ICI in a cohort of extensively pretreated ACC patients receiving different ICI treatment regimens. Further studies are needed to identify responders and to elucidate the predictive role of PD-L1 immunohistochemistry.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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