Nivolumab in Metastatic Adrenocortical Carcinoma: Results of a Phase 2 Trial

Author:

Carneiro Benedito A1ORCID,Konda Bhavana2,Costa Rubens B1,Costa Ricardo L B1,Sagar Vinay13,Gursel Demirkan B4,Kirschner Lawrence S2,Chae Young Kwang1,Abdulkadir Sarki A134,Rademaker Alfred5,Mahalingam Devalingam1,Shah Manisha H2,Giles Francis J1

Affiliation:

1. Developmental Therapeutics Program, Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois

2. Ohio State University Comprehensive Cancer Center, Columbus, Ohio

3. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

4. Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

5. Department of Preventive Medicine, Northwestern University, Chicago, Illinois

Abstract

Abstract Context Systemic treatment of metastatic adrenocortical carcinoma (ACC) remains limited to chemotherapy and mitotane. Preliminary evidence suggesting that antitumor immune responses can be elicited in ACC has fostered interest in checkpoint inhibitors such as anti–PD-1 nivolumab. Objective The primary endpoint was objective response rate according to the response evaluation criteria in solid tumors. Secondary endpoints were progression-free survival (PFS), overall survival, and safety. Design Single-arm, multicenter, phase 2 clinical trial with two-stage design. Setting Comprehensive cancer center. Patients Ten adult patients with metastatic ACC previously treated with platinum-based chemotherapy and/or mitotane as well as patients who declined front-line chemotherapy. Intervention Nivolumab (240 mg) IV every 2 weeks. Results Ten patients with metastatic ACC were enrolled between March and December 2016. The median number of doses of nivolumab administered was two. Three patients only received one treatment [one died of disease progression, one discontinued due to adverse events (AEs), one withdrew after beginning treatment]. The median PFS was 1.8 months. The median follow-up was 4.5 months (range, 0.1 to 25.6 months). Two patients had stable disease for a duration of 48 and 11 weeks, respectively. One patient had an unconfirmed partial response but discontinued the study due to an AE. Most AEs were grade 1/2. The most common grade 3/4 treatment-related AEs were aspartate aminotransferase and alanine aminotransferase elevations, mucositis, and odynophagia. Conclusion Nivolumab demonstrated modest antitumor activity in patients with advanced ACC. The nivolumab safety profile was consistent with previous clinical experience without any unexpected AEs in this population.

Funder

Bristol-Myers Squibb

Women's Board of Northwestern Memorial Hospital

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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