726P Circulating cell-free DNA-based biomarkers as a new tool for prognosis and surveillance of adrenocortical carcinoma | Ronchi CL, et al. | Annals of Oncology | Oct. 2023

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Adrenocortical carcinoma (ACC) is a rare aggressive endocrine cancer with heterogeneous behaviour. Disease surveillance relies on frequent imaging, which comes with significant radiation exposure. We investigated the role of circulating cell-free DNA (ccfDNA)-related biomarkers (BM) for prognostication and monitoring of ACC.


Data was collected from electronic medical system at our center between 2019 and 2022. Patients who were diagnosed as mACC and treated with A+T regardless of prior therapy were included. Patients accepted A 12 mg once daily PO from day 1 to 14 and T 200mg IV on day 1 every 3 weeks. Baseline characteristics were recorded. Objective response rate(ORR) and disease control rate(DCR) were evaluated according to RECIST v1.1 and treatment related adverse events(TRAE) according to CTCAE v5.0. Progression free survival(PFS) and overall survival(OS) were analyzed using Kaplan Meier method.


Overall, 37 patients were included. Median age was 50 years(19-76). 51.4%(19/37) were male. Median number of metastatic sites was 3. Median follow-up was 41 months. ORR was 35.1%(1 CR and 12 PR) and DCR was 78.4%(29/37). Median PFS was 8.2 months(95%CI 1.4-24.7) and median OS had not reached. Any grade TRAE rate was 89.2%(33/37) and grade 3/4 TRAE rate was 29.7%(11/37). No treatment related death was observed. Most common grade 3/4 TRAE included proteinuria(10.8%, 4/37), fatigue(8.1%, 3/37), adrenal crisis(5.4%, 2/37) and hepatic enzyme increase(5.4%, 2/37).


The combination of A and T showed promising clinical benefits with moderate toxicities in mACC patients. A+T might become a potential treatment option which need to be further confirmed in the randomized controlled clinical trial.