Real-world experience with pembrolizumab in patients with advanced soft tissue sarcoma

Liu, Jiayong; Fan, Zhengfu; Bai, Chujie; Li, Shu; Xue, Ruifeng; Gao, Tian; Zhang, Lu; Tan, Zhichao; Fang, Zhiwei

doi:10.21037/atm-21-49

Cited by 16 publications

(11 citation statements)

References 40 publications

(43 reference statements)

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“…Although the effect of sunitinib could not be evaluated in this study because of the limited number of patients treated with this drug ( n = 1), previous studies suggest these antiangiogenics could be a putative therapeutic option in the first-line treatment of metastatic ASPS [ 46 ]. Recent studies have also demonstrated a promising role of immune checkpoint inhibitors [ 28 , 47 , 48 ]. However, we could not evaluate the therapeutic efficacy of the immunotherapies or targeted drugs other than pazopanib because of the limited number of patients treated with these drugs.…”

Section: Discussionmentioning

confidence: 99%

Alveolar soft part sarcoma: progress toward improvement in survival? A population-based study

et al. 2022

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Background Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade. Methods One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017, identified from the Bone and Soft-Tissue Tumor Registry in Japan, were analyzed retrospectively. Results The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were > 25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors > 5 cm (5–10 cm, 81%; > 10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. Prolonged survival was seen in patients who received pazopanib treatment (p = 0.045), but not in those who received doxorubicin-based cytotoxic chemotherapy. Overall, improved DSS for metastatic ASPS has been observed since 2012 (5-year DSS, from 58 to 65%) when pazopanib was approved for advanced diseases, although without a statistically significant difference (p = 0.117). Conclusion The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted therapy encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.

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Section: Discussionmentioning

confidence: 99%

Alveolar soft part sarcoma: progress toward improvement in survival? A population-based study

et al. 2022

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“…However, response to ICIs has been reported to occur even in the absence of PD-L1 expression. [22][23][24][25] In addition, an angiosarcoma with a low TMB showing complete response to an ICI has also been reported, suggesting that TMB is also not entirely reliable in predicting response to immunotherapy. 26 In a study by Lam et al, 15 the authors found that the level of PD-L1 expression also correlated with the degree of T-lymphocyte infiltration in the tumor, an observation echoed by other studies.…”

Section: Discussionmentioning

confidence: 99%

Soft Tissue Leiomyosarcoma With Microsatellite Instability, High Tumor Mutational Burden, and Programmed Death Ligand-1 Expression Showing Pathologic Complete Response to Pembrolizumab: A Case Report

Tay

Yeong

Chen

et al. 2022

JCO Precision Oncology

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“…Although the effect of sunitinib could not be evaluated in this study because of the limited number of patients treated with this drug (n = 1), previous studies suggest these antiangiogenics could be a putative therapeutic option in the rst-line treatment of metastatic ASPS [43]. Recent studies have also demonstrated a promising role of immune checkpoint inhibitors [27,44,45]. However, we could not evaluate the therapeutic e cacy of the immunotherapies or targeted drugs other than pazopanib because of the limited number of patients treated with these drugs.…”

Section: Discussionmentioning

confidence: 99%

Alveolar Soft Part Sarcoma: Progress Toward Improvement in Survival? A Population-Based Study

Fujiwara

Nakata

Kunisada

et al. 2021

Preprint

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Background: Alveolar soft part sarcoma (ASPS) is a rare histological subtype of soft-tissue sarcoma, which remains refractory to conventional cytotoxic chemotherapy. We aimed to characterize ASPS and investigate whether the oncological outcome has improved over the past decade.Methods: One hundred and twenty patients with newly diagnosed ASPS from 2006 to 2017 were identified from the Bone and Soft-Tissue Tumor Registry in Japan. The Kaplan–Meier estimate and Cox proportional hazard model were used to investigate the survival outcomes and factors affecting prognosis.Results: The study cohort comprised 34 (28%) patients with localized ASPS and 86 (72%) with metastatic disease at presentation. The 5-year disease-specific survival (DSS) was 68% for all patients and 86% and 62% for localized and metastatic disease, respectively (p = 0.019). Metastasis at presentation was the only adverse prognostic factor for DSS (hazard ratio [HR]: 7.65; p = 0.048). Patients who were >25 years (80%; p = 0.023), had deep-seated tumors (75%; p = 0.002), and tumors >5 cm (5–10 cm, 81%; >10 cm, 81%; p < 0.001) were more likely to have metastases at presentation. In patients with localized ASPS, adjuvant chemotherapy or radiotherapy did not affect survival, and 13 patients (45%) developed distant metastases in the lung (n = 12, 92%) and brain (n = 2, 15%). In patients with metastatic ASPS (lung, n = 85 [99%]; bone, n = 12 [14%]; and brain n = 9 [11%]), surgery for the primary or metastatic site did not affect survival. The use of pazopanib significantly prolonged survival in patients who received systemic treatment (p = 0.045), whereas doxorubicin-based cytotoxic chemotherapy did not. Overall, a trend toward improved DSS for metastatic ASPS has been observed since 2012 (5-year, 58%–65%; p = 0.117), when pazopanib was approved for use in advanced disease.Conclusion: The national study confirmed a unique feature of ASPS with frequent metastasis to the lung and brain but an indolent clinical course. An overall trend toward prolonged survival after the introduction of targeted drugs encourages continuous efforts to develop novel therapeutic options for this therapeutically resistant soft-tissue sarcoma.

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Real-world experience with pembrolizumab in patients with advanced soft tissue sarcoma

Cited by 16 publications

References 40 publications

Alveolar soft part sarcoma: progress toward improvement in survival? A population-based study

Alveolar soft part sarcoma: progress toward improvement in survival? A population-based study

Soft Tissue Leiomyosarcoma With Microsatellite Instability, High Tumor Mutational Burden, and Programmed Death Ligand-1 Expression Showing Pathologic Complete Response to Pembrolizumab: A Case Report

Alveolar Soft Part Sarcoma: Progress Toward Improvement in Survival? A Population-Based Study

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