Adrenal Cortex Carcinoma

P1, N=48, Recruiting, St. Jude Children's Research Hospital | N=32 --> 48 | Trial completion date: Mar 2027 --> Mar 2028 | Trial primary completion date: Mar 2026 --> Mar 2027

P2, N=28, Recruiting, Instituto do Cancer do Estado de São Paulo | Active, not recruiting --> Recruiting

P1/2, N=25, Recruiting, Fundación de investigación HM | Phase classification: P2 --> P1/2

P1, N=104, Recruiting, RayzeBio, Inc. | Not yet recruiting --> Recruiting | Trial completion date: Oct 2032 --> Apr 2033

FOLH1 may be involved in tumor progression by regulating amino acid metabolic pathways and the immune microenvironment. It is a promising pan-cancer prognostic marker and synergistic target for immunotherapy.

Postoperative 18F-FDG PET/computed tomography (CT) demonstrated residual disease; steroid, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy achieved a marked complete metabolic response after six cycles-one of the most significant documented responses in primary adrenal NK/T-cell lymphoma. This case highlights diagnostic challenges of primary adrenal lymphoma (PAL), the need for histopathological confirmation in atypical masses, and suspicion for hematological malignancies with systemic symptoms and adrenal lesions.

P=N/A, N=21, Recruiting, Shanghai Jiao Tong University School of Medicine | Trial completion date: Dec 2025 --> Jun 2027 | Trial primary completion date: Jun 2025 --> Dec 2026

P2, N=39, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: Feb 2026 --> Feb 2027

Etomidate administration led to marked suppression of cortisol and aldosterone, while 11-deoxycorticosterone levels increased substantially. Interestingly, despite the elevated 11-deoxycorticosterone, serum potassium normalized, highlighting a complex interplay among mineralocorticoid precursors and active hormones in maintaining electrolyte balance.

The patient completed six cycles of adjuvant chemotherapy with tegafur-gimeracil-oteracil (S-1) plus oxaliplatin, and routine follow-up examinations showed no evidence of recurrence...The patient was treated with SOX chemotherapy combined with the PD-1 inhibitor tislelizumab...This case highlights the importance of vigilance for rare metastatic sites, such as the adrenal gland, in patients with advanced gastric cancer even after standardized postoperative surveillance. Systemic chemotherapy combined with immunotherapy may represent an effective treatment strategy for selected patients with metastatic gastric cancer.

Despite multiple adverse prognostic indicators, the patient has remained disease-free for over 5 years following adrenalectomy and adjuvant low-dose mitotane therapy. These findings suggest that GNAS activation may drive steroidogenesis while attenuating malignant progression, as demonstrated by integrated morphologic and genomic assessment in this case.

PRKD3 expression also correlated with immune checkpoint molecules including PD-1, PD-L1, and CTLA-4, supporting an immunosuppressive role, while context-dependent associations with TMB and MSI highlighted its potential influence on tumor immunogenicity and responsiveness to immune checkpoint blockade. Collectively, these findings identify PRKD3 as a potential context-dependent modulator of tumor biology, prognosis, and immune interactions, underscoring its potential as a biomarker of diagnostic, prognostic, and therapeutic relevance in precision oncology.