Would you offer immunotherapy first line for patients with adrenocortical carcinoma outside of a clinical trial?
The phase 2 trial of pembrolizumab in JCO 2019 showed efficacy, and I have patients preferring to avoid chemotherapy.
Answer from: Medical Oncologist at Community Practice
The short answer is yes (pembrolizumab and mitotane).The long answer is I explain to the patient that the standard of care is still EDP + mitotane based on the Fassnacht NEJM 2012 paper. Immunotherapy is not FDA approved or recommended by the NCCN. However, several of us who specialized in adrenal c...
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Answer from: Medical Oncologist at Academic Institution
I have not been using ICI as first-line therapy for ACC unless there are concerns for tolerability to EDP. We also do usually not include mitotane in EDP in patients with nonfunctional ACCs. Given the somewhat promising activity of pembrolizumab in ACC, it is a very reasonable second-line choice as ...