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Furthermore, recent immunotherapy clinical trials have demonstrated significant immunoresistance among cortisol\u2010secreting ACC (CS\u2010ACC) patients when compared to their non\u2010cortisol\u2010secreting (nonCS\u2010ACC) counterparts. The immunosuppressive role of excess glucocorticoid therapies and hypersecretion is known; however, the impact of the cortisol hypersecretion on ACC tumour microenvironment (TME), immune expression profiles and immune cell responses remain largely undefined. In this study, we characterized the TME of ACC patients and compared the immunogenomic profiles of nonCS\u2010ACC and CS\u2010ACC tumours to assess the impact of differentially expressed genes (DEGs) by utilizing The Cancer Genome Atlas (TCGA) database. Immunogenomic comparison (CS\u2010 vs. nonCS\u2010ACC tumour TMEs) demonstrated an immunosuppressive expression profile with a direct impact on patient survival. We identified several primary prognostic indicators and potential targets within ACC tumour immune landscape. Differentially expressed immune genes with prognostic significance provide additional insight into the understanding of potential contributory mechanisms underlying failure of initial immunotherapeutic trials and poor prognosis of patients with CS\u2010ACC.<\/jats:p>","DOI":"10.1111\/jcmm.16936","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T09:41:06Z","timestamp":1634809266000},"page":"10061-10072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Integrative computational immunogenomic profiling of cortisol\u2010secreting adrenocortical carcinoma"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4498-6647","authenticated-orcid":false,"given":"Jordan J.","family":"Baechle","sequence":"first","affiliation":[{"name":"School of Medicine Meharry Medical College Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Hanna","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology &amp; Endocrine Surgery Department of Surgery Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konjeti R.","family":"Sekhar","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology &amp; Endocrine Surgery Department of Surgery Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Rathmell","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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