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Updated: May 16, 2026

Predictive Immune Modeling of Solid Tumors
Published on: February 25, 2020
Pseudo-Progression Observed During Immune Checkpoint Inhibitor Therapy for Advanced Adrenocortical Carcinoma
Moeto Shimoda1, Shinji Ohtake1,2, Tetsuya Aoki1
1Department of Urology Yokosuka Kyosai Hospital Yokohama Japan.
Introduction:
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Recent studies suggest that immune checkpoint inhibitors exhibit antitumor activity in selected ACC patients.
Case Presentation:
We report a case of a 49-year-old man with advanced ACC and pulmonary metastasis treated with EDP-M chemotherapy, followed by pembrolizumab based on high tumor mutational burden (TMB, 27.1/Mb). Despite suspected pseudo-progression, transient tumor shrinkage was observed. However, the patient died of liver failure 9 months after diagnosis.
Conclusion:
This case suggests a therapeutic role for ICIs in ACC. Moreover, it highlights the importance of TMB and immune RECIST criteria in evaluating treatment response.
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