Case Report: An exceptional response to neoadjuvant radiotherapy and chemotherapy in undifferentiated pleomorphic sarcoma following checkpoint inhibitor use

Abstract

Undifferentiated pleomorphic sarcoma (UPS), a subtype of soft tissue sarcoma (STS), is an uncommon malignancy associated with a poor prognosis. As with other forms of sarcoma, surgical resection remains the only form of treatment with curative potential. The role of perioperative systemic therapy has not been definitively elucidated. Due to high recurrence rates and metastatic potential, management of UPS can pose a difficult task for clinicians. In cases of unresectable UPS due to anatomic limitations and in patients with comorbidities and poor performance status (PS), management options are limited. We describe a patient with UPS involving the chest wall with poor PS who achieved complete response (CR) following neoadjuvant chemotherapy and radiation in the setting of prior immune-checkpoint inhibitor (ICI) therapy.

Undifferentiated Pleomorphic Sarcoma of the Sigmoid Colon: A case report

“…Tumor size, location, degree of differentiation and completeness of surgery are closely related to the prognosis of UPS [5] . The effects of postoperative adjuvant radiotherapy and chemotherapy have not been reported, but some studies have shown that compared with surgery alone, although adjuvant radiotherapy and chemotherapy can't improve the overall survival rate, they can significantly improve the local control rate of high-grade soft tissue sarcoma [2] .…”

“…Early and complete resection of the tumor is the main treatment for UPS. Although some studies have shown that postoperative adjuvant radiotherapy and chemotherapy have a certain local control rate [2] , the effect of radiotherapy and chemotherapy is not completely certain, and more cases are needed to further study its efficacy.…”