派姆单抗和帕唑帕尼治疗晚期未分化多形性肉瘤的良好和持续反应:1例报告。

Clinical Sarcoma Research Pub Date : 2020-07-09 eCollection Date: 2020-01-01 DOI:10.1186/s13569-020-00133-9
Shalabh Arora, Sameer Rastogi, Shamim Ahmed Shamim, Adarsh Barwad, Maansi Sethi
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引用次数: 12

摘要

背景:传统的细胞毒性药物和帕唑帕尼被批准用于晚期软组织肉瘤,但反应率低,生存获益有限。最近,免疫检查点抑制剂显示出有临床意义的活性。帕唑帕尼联合免疫疗法在其他各种恶性肿瘤中显示出协同作用,但在晚期软组织肉瘤中尚未充分探索。病例介绍:一名63岁的转移性未分化多形性肉瘤妇女在接受两种姑息性联合化疗后进展进展-阿霉素与奥拉拉单抗,吉西他滨与多西他赛。鉴于症状明显,她接受帕唑帕尼联合派姆单抗治疗。她有显著的放射学和临床改善,在10个月的治疗中具有可控的毒性和持续的反应。结论:未分化多形性肉瘤是一种免疫活跃的软组织肉瘤亚型,特别适合免疫检查点抑制剂。Pazopanib与免疫检查点抑制剂是一种耐受性良好的组合,但迄今尚未被充分探索,可能在晚期肉瘤中提供显着的临床益处-这一发现值得在临床试验中进一步评估。
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Good and sustained response to pembrolizumab and pazopanib in advanced undifferentiated pleomorphic sarcoma: a case report.

Background: Conventional cytotoxic agents and pazopanib are approved for advanced soft tissue sarcomas but have low response rates and modest survival benefits. Recently, immune checkpoint inhibitors have shown clinically meaningful activity. The combination of pazopanib and immunotherapy has shown synergism in various other malignancies but has not been fully explored in advanced soft tissue sarcomas.

Case presentation: A 63 year old woman with metastatic undifferentiated pleomorphic sarcoma progressed after two lines of palliative combination chemotherapy-doxorubicin with olaratumab, and gemcitabine with docetaxel. In view of significant symptoms, she was treated with pazopanib in combination with pembrolizumab. She had remarkable radiological and clinical improvement, with a manageable toxicity profile and an ongoing response at ten months of therapy.

Conclusions: Undifferentiated pleomorphic sarcoma is an immunologically active subtype of soft tissue sarcoma, which is particularly amenable to immune checkpoint inhibitors. Pazopanib with immune checkpoint inhibitors is a well-tolerated, yet hitherto underexplored combination that may offer significant clinical benefit in advanced sarcomas-this finding warrants further evaluation in clinical trials.

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期刊介绍: Clinical Sarcoma Research considers for publication articles related to research on sarcomas, including both soft tissue and bone. The journal publishes original articles and review articles on the diagnosis and treatment of sarcomas along with new insights in sarcoma research, which may be of immediate or future interest for diagnosis and treatment. The journal also considers negative results, especially those from studies on new agents, as it is vital for the medical community to learn whether new agents have been proven effective or ineffective within subtypes of sarcomas. The journal also aims to offer a forum for active discussion on topics of major interest for the sarcoma community, which may be related to both research results and methodological topics.
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