727P - Clinical outcome of anlotinib (A) and tislelizumab (T) in metastatic adrenocortical carcinoma(mACC): A one-arm single-center experience

Background

Adrenocortical carcinoma is a rare malignant disease with few treatment options. The combination of etoposide, doxorubicin and cisplatin with or without mitotane known as EDP/M, is recommended as first -line regimen based on FIRMACT study. It shows limited efficacy and intolerable toxicities. There is no standard second- line treatment, but antiangiogenesis therapy and PD-1 checkpoint inhibitors are widely applied in clinical practice. Here, we report the efficacy and safety of A, a multi-targeted tyrosine kinase inhibitor that inhibits VEGFR, FGFR, PDGFR, and c-Kit, combined with T, an immune checkpoint inhibitor, in the treatment of mACC.

Methods

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.

Results

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).

Conclusions

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.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.