Current Status and Future Direction in the Treatment of Advanced Adrenocortical Carcinoma
Chulkue Pak1, Shinkyo Yoon1, Jae Lyun Lee1
1Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
Purpose Of Review:
To provide a comprehensive overview of the current understanding and developments in the treatment options for adrenocortical carcinoma (ACC), focusing on the strategies utilized for advanced disease.
Recent Findings:
Research has delved into the genomic landscape of ACC, revealing potential targets for therapy. Despite the failure of inhibitors aimed at the insulin like growth factor 1(IGF-1) receptor, other approaches, including vascular endothelial growth factor receptor (VEFGR) tyrosine kinase inhibitors and immune checkpoint inhibitors, are being investigated. There are also ongoing trials of combination treatments such as lenvatinib with pembrolizumab and cabozantinib with atezolizumab. ACC remains a challenging malignancy with limited effective treatment options. Although EDP-M stands as the frontline treatment, the search for effective second-line therapies is ongoing. Targeted therapies and immunotherapies, especially in combination regimens, are demonstrating potential and are the subject of continued research. The evolving genomic landscape emphasizes the significance of targeted therapies and the need for further in-depth studies to solidify effective treatment regimens for ACC.
Insights
Adrenocortical carcinoma (ACC) treatment is evolving, with targeted therapies and immunotherapies showing promise for advanced disease. Ongoing research focuses on combination regimens to improve outcomes for this challenging cancer.
Area of Science:
- Oncology
- Genomics
- Pharmacology
Background:
- Adrenocortical carcinoma (ACC) is a rare and aggressive endocrine malignancy.
- Effective treatment options for advanced ACC remain limited, posing a significant clinical challenge.
Purpose of the Study:
- To review current understanding and developments in adrenocortical carcinoma treatment.
- To focus on therapeutic strategies for advanced stages of the disease.
Main Methods:
- Comprehensive literature review of genomic landscape studies in ACC.
- Analysis of ongoing clinical trials for targeted therapies and immunotherapies.
- Evaluation of combination treatment regimens.
Main Results:
- Genomic research in ACC has identified potential therapeutic targets.
- While IGF-1 receptor inhibitors have shown limited success, VEFGR tyrosine kinase inhibitors and immune checkpoint inhibitors are under investigation.
- Combination therapies, such as lenvatinib with pembrolizumab and cabozantinib with atezolizumab, are in clinical trials.
- EDP-M is the current frontline treatment, but effective second-line options are still sought.
Conclusions:
- ACC remains a difficult-to-treat malignancy.
- Targeted therapies and immunotherapies, particularly in combination, show potential for improving ACC treatment.
- Further research is crucial to establish effective treatment regimens based on the evolving genomic understanding of ACC.
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