Immunotherapy Use in Adrenocortical Carcinoma with Encouraging Results: A Case Report

This case report detailed the use of pembrolizumab, a PD1 inhibitor, in treating a 19-year-old female patient with metastatic adrenocortical carcinoma (ACC), a rare cancer with poor prognosis. The patient initially presented with symptoms of Cushing’s Syndrome and underwent right adrenalectomy. Despite initial disease-free status post-surgery, metastases were later found in the lungs. Pembrolizumab was administered every 3 weeks for 2 years, resulting in a significant reduction in pulmonary nodules and stable disease for 1 year post-treatment. The main side effect was primary adrenal insufficiency, managed with fludrocortisone and glucocorticoids. The patient showed a durable 36-month response to the therapy, indicating promising potential for pembrolizumab in treating microsatellite stable ACC.