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Recent advances in immunotherapy have resulted in a more effective treatment of melanomas that spread to other parts of the body.  However, despite these advances CU Researchers and Clinicians continued to encounter the same problem, cancer cells that spread to the adrenal glands were not affected by immunotherapy drugs.  Furthermore, those with adrenal gland metastases were given worse prognoses and outcomes.   According to Dr. Bill Robinson while patients were having a complete disappearance at other sites of metastasis, the adrenal gland had no response, prompting further research into the overall likelihood and frequency of this occurring. “What we found is that the adrenal glands are in some way a privileged site in the body.  Somehow the immune system is unable to trigger an active immune response in the adrenal gland. The immune cells are there in the adrenal gland, but they are unable to function" says Dr. Robinson.

 

One theory Dr. Robinson and his colleagues have as to why the micro-environment of the adrenal gland makes it unresponsive to checkpoint inhibitors is that the secretion of corticosteroids could potentially be blocking the immune cells. Until Dr. Robinson and his colleagues can fully test this theory, he recommends that adrenal gland metastasis in melanoma be surgically removed.   

“If left untreated, the glands can grow to a very large size, bleed, and cause a lot of local problems. If you don’t take them out, they’re going to continue to be a focus of further spread of the melanoma as well” says Dr. Robinson.