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

This case report described a 19-year-old Caucasian female with metastatic adrenocortical carcinoma (ACC) who showed a promising response to the PD1 inhibitor pembrolizumab. After initial treatment with right adrenalectomy and radiation, she experienced disease recurrence with lung metastases. Pembrolizumab therapy was administered for 2 years, resulting in a significant reduction in pulmonary nodules and a durable response for 1 year post-therapy. The main side effect was primary adrenal insufficiency, managed with fludrocortisone and glucocorticoids. This case highlighted a 36-month response to pembrolizumab in a patient with microsatellite stable ACC, suggesting potential benefits of immunotherapy in such cases.