There’s not a whole lotta data to guide treatment decisions for adrenocortical carcinoma (ACC). This genomic analysis of ACC first used a training cohort of 144 patients with ACC who had already undergone “pan-genomic” testing to develop a targeted gene panel that could predict better or worse outcomes by classifying each tumor into one of three molecular subgroups: A1, A2 or A3-B. This is a situation where you wanna land on the B-team because respective survival rates at 5 years among those with resected stage I-III disease were 9%, 45%, and 82%. Those with stage IV disease primarily fell in groups A1 or A2 and just did poorly across the board. These groupings again proved independently prognostic in a prospective validation cohort of 224 patients treated for ACC at 21 centers in Europe. Respective median disease-free survival times across molecular subgroups were 14 months, 29 months, and not reached. TBL: New molecular subgroups could help us determine which patients with resected non-metastatic adrenocortical carcinoma can safely skip the toxicity of adjuvant therapies. | Assié, JAMA Oncol 2019


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