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An important function of your immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses proteins (or "checkpoints") on immune cells that need to be turned on (or off) to start an immune response. Adrenal cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Drugs that target these checkpoint proteins, help restore the immune response against adrenal cancer cells.

Checkpoint (PD-1) inhibitor

Pembrolizumab (Keytruda) is a drug that targets PD-1, a checkpoint protein on immune cells called T cells.  By blocking PD-1, pembrolizumab boosts the immune response against adrenal cancer cells.

It can be used with or without mitotane to treat advanced adrenal cancer.

This drug is given as an intravenous (IV) infusion, typically every 3 or 6 weeks.

Possible side effects of immune checkpoint inhibitors

Side effects of these drugs can include fatigue, cough, nausea, skin rash, poor appetite, constipation, and diarrhea.

Other, more serious side effects occur less often.

Infusion reactions:  Some people might have an infusion reaction while getting these drugs. This is like an allergic reaction, and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your doctor or nurse right away if you have any of these symptoms while getting these drugs.

Autoimmune reactions: These drugs remove one of the protections on the body's immune system. Sometimes the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

It’s very important to report any new side effects to your health care team quickly. If serious side effects do occur, treatment may need to be stopped and you may get high doses of corticosteroids to suppress your immune system.