Pembrolizumab in the Treatment of Advanced, Progressive Adrenocortical Carcinoma.

Exclusion Criteria

• •1. Pre-treatment with an immune checkpoint inhibitor
• •2. Any cancer therapy within the last 7 days (including mitotane)
• •3. Persistent side effects of previous anti-cancer therapy in the\> G1 stage or after surgical treatment (exception: alopecia)
• •4. Immunosuppressive therapy present or conducted within the last 4 weeks
• •5. Glucocorticoid therapy in a dose higher than the replacement dose (subject to the permitted use: inhaled or topical steroids, single administration of a steroid, e.g. in case of an allergic reaction to contrast, use of mineralocorticosteroids, steroids in the course of asthma or COPD)
• •6. Previous allograft marrow or organ transplant
• •7. Current or diagnosed in the last 2 years autoimmune disease with the exception of vitiligo, psoriasis not requiring systemic treatment, autoimmune disease of the thyroid gland
• •8. Active or previously documented inflammatory disease of the large intestine
• •9. Previous non-infectious pneumonia requiring steroid therapy
• •10. Hepatitis B or C
• •11. Active tuberculosis
• •12. Current active infection requiring systemic treatment
• •13. Symptomatic, untreated central nervous system (CNS) metastases (exception: patients with asymptomatic CNS metastases with prior surgery or radiotherapy and no history of intracranial bleeding)
• •14. Circulatory failure NYHA ≥3
• •15. Corrected QT interval\> 500 ms
• •16. Significant coexisting disease, including neoplastic, except for basal cell carcinoma of the skin, carcinoma in situ: prostate, cervix, breast
• •17. Other significant comorbid disease that, in the investigator's opinion, would pose risks to the patient during therapy
• •18. Pregnancy or breastfeeding
• •19. Patients requiring dialysis
• •20. The patient's inability to meet the requirements specified in the study protocol
• •21. Vaccination with live vaccine within 3 months before starting treatment