Maximizing Immunotherapy in Sarcoma Using Histology, Biomarkers and Novel Approaches

Abstract

Sarcomas are rare tumours with variable treatment responsiveness. Immunotherapy represents a promising approach but has yet to be fully realized. Clinical trials have shown modest response rates to checkpoint blockade (overall response rate: 5–18%) but with wide variability across histologic subtypes (up to 70% in small series). Biomarkers may help further predict response, but traditional markers are rarely expressed and less useful within sarcoma. An overarching immune classification combining several biomarkers offers better predictive validity. Exciting novel approaches include leveraging cancer testis antigens for adoptive T-cell therapies, identifying synergistic combination regimens and targeting epigenetic mechanisms to improve immune responsiveness.