Sustained response to anti IGFR-1R monoclonal antibody combined with docetaxel in a patient with metastatic adrenocortical carcinoma Abstract #64

Introduction: Adrenocortical carcinoma (ACC) is a rare neoplasm with poor prognosis. Treatment results in advanced disease are disappointing and median survival is less than 12 months. There is no standard chemotherapy, even though mitotane and cisplatin-based regimens are frequently used with limited efficacy. In vitro data suggest that overexpressed insulin growth factor-2 (IGF-2) acting via the IGF-1 receptor (IGF-1R) is relevant for ACC and that the IGF-1R and 2R pathway is a promising target.
Aim(s): We report the case of a patient with relapsed ACC progressing on mitotane, who experienced prolonged disease stabilization (SD) while receiving an anti IGFR-1R monoclonal antibody (MoAb) combined with docetaxel.
Materials and methods: In March 2006, a 69-year-old female patient complained of severe hypertension and persistent back pain; CT scan revealed an 8 cm left adrenal mass, with increased levels of cortisol (550 nmol/l, < 135), aldosterone (1500 pmol/l, < 444) and hypokaliemia (2 mmol/l). Plasma metanephrines and urinary catecholamines were normal. She underwent left adrenalectomy, with a diagnosis of a well-differentiated ACC, with low-intermediate mitotic rate, focal necroses and angiolymphatic invasion. In December 2008, a CT scan showed lung, bone and peritoneal metastases; escalating doses of mitotane (up to 3 gr daily) were administered for three months, with objective and symptomatic progression (bone and abdominal pain). Because of the good performance status, tumor-related symptoms and lack of standard options, after informed consent, in March 2009, the patient started a phase I treatment with the anti IGFR-1R MoAb AVE1642 (6 mg/kg) in combination with docetaxel (100 mg/mq), given intravenously every three weeks.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Sara De Dosso

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