Case Report: triple therapy with pembrolizumab, ipilimumab, and lenvatinib in mitotane- and radiation-refractory, cortisol-secreting stage IV adrenocortical carcinoma: a genomically guided approach - Summary - MDSpire
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Case Report: triple therapy with pembrolizumab, ipilimumab, and lenvatinib in mitotane- and radiation-refractory, cortisol-secreting stage IV adrenocortical carcinoma: a genomically guided approach
To report a case of stage IV adrenocortical carcinoma (ACC) resistant to conventional therapies and to explore the effectiveness of a combination treatment based on genomic profiling.
Key Findings:
The patient showed a remarkable clinical response with resolution of Cushing’s syndrome.
Follow-up imaging confirmed a sustained partial response and regression of metastatic lesions.
Genomic analysis indicated a high tumor mutational burden and specific alterations linked to immune resistance, including MSH6 and TP53 mutations.
Interpretation:
This case illustrates the potential of personalized combination immunotherapy in treating refractory ACC, highlighting the importance of detailed genomic profiling.
Limitations:
Single case study limits generalizability of findings.
Long-term outcomes and safety of the combination therapy remain to be established.
Further research is needed to validate the effectiveness of this treatment approach.
Conclusion:
The integration of genomic analysis into treatment planning can enhance therapeutic strategies for patients with advanced ACC, potentially improving outcomes.
