Single Agent Pembrolizumab in Subjects With Advanced Adrenocortical Carcinoma

Inclusion Criteria: * Be willing and able to provide written informed consent for the trial. * Be ≥ 18 years of age on day of signing informed consent. * Have histologically- or cytologically- confirmed unresectable or metastatic ACC that is considered incurable by local therapies. * Have an ECOG performance status of 0 or 1. * Have measurable disease based on RECIST v1.1 * Have provided tissue for PD-L1 biomarker analysis from either archived tissue or a newly obtained core or excisional biopsy. * Consent for use of archived tissue for research purposes. * Demonstrate adequate organ function, all screening labs should be performed within 28 days of treatment initiation. Hematological * Absolute neutrophil count (ANC) ≥1,500 /mcL * Platelets ≥100,000 / mcL Renal * Serum creatinine ≤1.5 X upper limit of normal (ULN) OR Measured or calculateda creatinine clearance (GFR can also be used in place of creatinine or CrCl) ≥60 mL/min for subject with creatinine levels \> 1.5 X institutional ULN Hepatic * Serum total bilirubin ≤ 1.5 X ULN OR Direct bilirubin ≤ ULN for subjects with total bilirubin levels \> 1.5 ULN * AST (SGOT) and ALT (SGPT) ≤ 2.5 X ULN OR ≤ 5 X ULN for subjects with liver metastases Coagulation * International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants * Activated Partial Thromboplastin Time (aPTT) ≤1.5 X ULN unless …