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The results of five clinical trials using different ICIs are heterogeneous and overall disappointing with objective response in only 17 (14%) of 121 treated patients ( The tumour microenvironment of ACC has been reported to be depleted of T lymphocytes giving rise to the notion of ACC as an immunologically “cold” tumour entity ( Recently, our group has used clinical data of steroid hormone secretion together with IHC for T cell markers in 146 ACC tumours and found an immunosuppressive effect of clinical GC excess on T cell infiltration ( The Wnt/β-catenin pathway has been suggested as an additional cause for an immunologically silent tumour microenvironment in several types of cancer ( CTNNB1 itself or by mutations in the upstream pathway gene ZNRF3 ( Established roles of canonical Wnt/β-catenin signalling include proliferation, apoptosis, migration and tissue homeostasis ( Figure 1

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Michaela the star of the SA girls The baby in the SA team, Michaela Fletcher, posted the best score of the South African girls (two over par 74) in the first round of the Harder German Junior Masters being played at Golfclub Gut Neuzenhof in Heddesheim, Germany