scholarly journals Long-Term Remission with Ipilimumab/Nivolumab in Two Patients with Different Soft Tissue Sarcoma Subtypes and No PD-L1 Expression

2021 ◽  
pp. 459-465
Author(s):  
Maggie Zhou ◽  
Nam Bui ◽  
Marta Lohman ◽  
Matt van de Rjin ◽  
Gloria Hwang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Treatment ◽  
Checkpoint Inhibitor ◽  
Inhibitor Therapy ◽  
Genetic Mutations ◽  
Advanced Soft Tissue Sarcoma ◽  
Solid Malignancies ◽  
Checkpoint Inhibitor Therapy

Checkpoint inhibitor therapy has been shown to improve outcomes in multiple solid malignancies; however, data are limited in soft tissue sarcoma. We present two cases of patients with advanced soft tissue sarcoma of different subtypes (dedifferentiated liposarcoma and myxofibrosarcoma) with zero percent PD-L1 expression by immunohistochemistry who were treated with ipilimumab and nivolumab followed by maintenance nivolumab. Both patients had failed multiple lines of systemic treatment and experienced long-term remission after starting ipilimumab and nivolumab. Genetic testing revealed that no genetic mutations were found in common between the two cases. One patient received concurrent cryoablation, which may have sensitized his tumor to immunotherapy. Checkpoint inhibitor therapy may improve outcomes in soft tissue sarcoma regardless of PD-L1 status, especially when combined with cryoablation. Studies are needed to evaluate whether treatment response varies by sarcoma subtype and what molecular markers can be used to guide patient selection.

Systemic Treatment of Cutaneous Adverse Events After Immune Checkpoint Inhibitor Therapy

Dermatitis ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alexandria M. Brown ◽  
Wylie Masterson ◽  
Jonathan Lo ◽  
Anisha B. Patel
Keyword(s):  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Systemic Treatment ◽  
Checkpoint Inhibitor ◽  
Inhibitor Therapy ◽  
Checkpoint Inhibitor Therapy

Cures with B-Raf inhibitors as single agents in metastatic B-Raf mutated melanoma: Curb your enthusiasm?

2020 ◽  
pp. 107815522097507
Author(s):  
Constantin A Dasanu
Keyword(s):  
Radiation Therapy ◽  
Malignant Melanoma ◽  
Clinical Outcome ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Inhibitor Therapy ◽  
Checkpoint Inhibitor Therapy ◽  
Favorable Clinical Outcome

Development of brain metastases during treatment with B-raf/MEK inhibitors for malignant melanoma tends to be more frequent than during immune checkpoint inhibitor therapy. Long-term responders to B-Raf inhibitors with or without MEK inhibition should be monitored very closely clinico-radiologically for a potential relapse. In addition to surgery and/or radiation therapy, single or dual immune checkpoint inhibitor therapy should be started without delay in this setting to ensure a favorable clinical outcome.

scholarly journals Clinical Outcome of Systemic Treatment for Advanced Soft Tissue Sarcoma: Real-Life Perspective in Japan

2020 ◽  
Vol Volume 14 ◽  
pp. 4215-4220
Author(s):  
Tomoki Nakamura ◽  
Kunihiro Asanuma ◽  
Tomohito Hagi ◽  
Akihiro Sudo
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Clinical Outcome ◽  
Systemic Treatment ◽  
Real Life ◽  
Advanced Soft Tissue Sarcoma

scholarly journals The Optimal Second-Line Systemic Treatment Model for Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: A Bayesian Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Ze-Jiang Zhan ◽  
Wen-Yu Yao ◽  
Fang Zhang ◽  
Wen-Ze Qiu ◽  
Kai- Liao ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Systemic Treatment ◽  
Checkpoint Inhibitor ◽  
Meta Analysis ◽  
Inhibitor Therapy ◽  
Treatment Model ◽  
Second Line ◽  
Checkpoint Inhibitor Therapy

BackgroundThe optimal second-line systemic treatment model for recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains controversial. A Bayesian network meta-analysis (NMA) was performed to address this issue with regard to efficacy and toxicity.MethodsBy searching MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials and Web of Science, we extracted eligible studies. Efficacy, represented as overall survival (OS) and progression-free survival (PFS), and overall toxicity, represented as ≥ grade 3 severe acute events (sAE), were assessed to compare the following 7 treatment models through an NMA: standard-of-care therapy (SoC), single targeted therapy different from SoC (ST), double targeted therapy (DT), targeted therapy combined with chemotherapy (T+C), single immune checkpoint inhibitor therapy (SI), double immune checkpoint inhibitor therapy (DI) and single chemotherapy different from SoC (SC). Rank probabilities according to the values of the surface under the cumulative ranking curve (SUCRA) were separately determined for efficacy and toxicity.ResultsIn total, 5285 patients from 24 eligible studies were ultimately screened, with 5184, 4532 and 4026 involved in the NMA of OS, PFS and sAE, respectively. All qualifying studies were absent from first-line immune checkpoint inhibitor therapy. In terms of OS, SI was superior to the other treatments, followed by DI, ST, T+C, SoC, DT and SC. Other than SI and SC, all treatments tended to be consistent, with hazard ratios (HRs) close to 1 between groups. For PFS, ST ranked first, while DT ranked last. For the toxicity profiles, compared with the other models, SI resulted in the lowest incidences of sAE, with statistical significance over SoC (odds ratio [OR] 0.31, 95% credible interval [CrI] 0.11 to 0.90), ST (OR 0.23, 95% CrI 0.06 to 0.86) and DT (OR 0.11, 95% CrI 0.02 to 0.53), while DT was the worst. When the SUCRA values of OS and sAE were combined, a cluster plot illustrated the superiority of SI, which demonstrated the best OS and tolerability toward sAE.ConclusionFor R/M HNSCC patients without immune checkpoint inhibitors in the first-line setting, SI may serve as the optimal second-line systemic treatment model, demonstrating the best OS and least sAE.

scholarly journals Advanced Soft Tissue Sarcoma: Systemic Treatment Patterns and Survival in Germany

2016 ◽  
Vol 19 (7) ◽  
pp. A760 ◽  
Author(s):  
DS Mytelka ◽  
M Lorenzo ◽  
D Stafkey-Mailey ◽  
Y D'Yachkova ◽  
SP Nagar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Treatment ◽  
Treatment Patterns ◽  
Advanced Soft Tissue Sarcoma

Long-Term Outcome of Isolated Limb Perfusion in Advanced Soft Tissue Sarcoma of the Extremity

2012 ◽  
Vol 19 (6) ◽  
pp. 1800-1807 ◽  
Author(s):  
R. Olofsson ◽  
P. Bergh ◽  
Ö. Berlin ◽  
K. Engström ◽  
B. Gunterberg ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Isolated Limb Perfusion ◽  
Advanced Soft Tissue Sarcoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Limb Perfusion

scholarly journals Systemic treatment in advanced soft tissue sarcoma: what is standard, what is new

BMC Medicine ◽  
2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Anna Maria Frezza ◽  
Silvia Stacchiotti ◽  
Alessandro Gronchi
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Treatment ◽  
Advanced Soft Tissue Sarcoma

Long-term evaluation of the novel radioenhancer NBTXR3 plus radiotherapy in patients with locally advanced soft tissue sarcoma treated in the phase II/III Act.In.Sarc trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11544-11544
Author(s):  
Sylvie Bonvalot ◽  
Piotr Rutkowski ◽  
Juliette Thariat ◽  
Sebastien Carrère ◽  
Anne Ducassou ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Functional Outcome ◽  
Locally Advanced ◽  
Intratumoral Injection ◽  
Post Treatment ◽  
Preoperative Treatment ◽  
Advanced Soft Tissue Sarcoma

11544 Background: NBTXR3, a novel radioenhancer activated by radiotherapy (RT) demonstrated superior efficacy, as preoperative treatment, in patients with locally advanced soft tissue sarcoma (LA STS), compared to RT alone. Primary endpoint of pCR rate was 16% vs 8% (p=0.044) and R0 margin rate was 77% vs 64% (p=0.042) (Bonvalot et al. Lancet Oncol. 2019). No modification of the early safety profile of RT was observed, leading to market authorization. Here we report on the long-term safety, limb function and quality of life. Methods: This phase II/III randomized (1:1), international trial included adult patients with LA STS of the extremity or trunk wall, requiring preoperative RT (NCT02379845). Patients were treated with either a single intratumoral injection of NBTXR3 (volume equivalent to 10% of tumor volume, at 53.3g/L) plus EBRT (arm A), or EBRT alone (arm B) (50 Gy in 25 fractions), followed by surgery. The primary and main secondary efficacy endpoints were previously reported. Safety of NBTXR3+RT, as preoperative treatment, was evaluated as secondary endpoint. We present the safety analyses done in the “all treated population”, with data recorded during at least a two-year follow-up. Important parameters related to HR-QoL, including functional outcome were studied using the EQ-5D, RNLI, TESS and MSTS questionnaires. Results: Patients had at least two-year follow-up and the lost to follow-up rate was very low (1.9%). RT-related SAEs were observed in 11.2% (10/89) vs 13.3% (12/90) in A vs B. Post-treatment AEs, any grade, were observed in 51.7% (46/89) vs 57.8% (52/90) and serious post-treatment AEs in 13.5% (12/89) vs 24.4% (22/90) of patients in A vs B. Second primary cancer was observed in 1 patient in arm A and 6 patients in arm B. Long-term safety continues to demonstrate that NBTXR3 plus RT has no impact on post-surgical wound complications (24.7% vs 36.7%, A vs B). Furthermore, the evaluation of radiation late toxicities in limbs such as fibrosis (4.5% vs 7.7%), arthrosis (2.2% vs 0.0%) and edema (6.7% vs 2.2%) that may alter limb function showed no difference between arms. Accordingly, HR-QoL evaluation yielded no difference in functional outcome. In addition, the intratumoral injection of NBTXR3 did not induce cancer cell seeding at the former tumor site. Finally, sequelae or chronic tissue disturbances at the former tumor localization were similar in both treatment arms, confirming that the increase of energy dose deposit and the physical presence of NBTXR3 did not impact post-treatment limb functions. Conclusions: The long-term safety results demonstrate that the addition of NBTXR3 to EBRT neither added toxicity nor modified the bystander effect of RT. The results presented here associated with the efficacy data reported previously reinforce the favorable benefit-risk ratio of the use of NBTXR3 in patients with LA STS. Clinical trial information: NCT02379845.

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