Arora Shalabh, Rastogi Sameer, Shamim Shamim Ahmed, Barwad Adarsh, Sethi Maansi
Department of Medical Oncology, Dr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Clin Sarcoma Res. 2020 Jul 9;10:10. doi: 10.1186/s13569-020-00133-9. eCollection 2020.
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.
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.
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.
传统细胞毒性药物和帕唑帕尼已被批准用于晚期软组织肉瘤，但缓解率低且生存获益有限。最近，免疫检查点抑制剂已显示出具有临床意义的活性。帕唑帕尼与免疫疗法的联合在其他多种恶性肿瘤中已显示出协同作用，但在晚期软组织肉瘤中尚未得到充分探索。
一名63岁患有转移性未分化多形性肉瘤的女性，在接受了两线姑息性联合化疗（阿霉素联合奥拉单抗，吉西他滨联合多西他赛）后病情进展。鉴于症状严重，她接受了帕唑帕尼联合派姆单抗治疗。她在影像学和临床方面均有显著改善，毒性反应可控，且在治疗10个月时仍有持续缓解。
未分化多形性肉瘤是软组织肉瘤的一种免疫活性亚型，尤其适合免疫检查点抑制剂治疗。帕唑帕尼与免疫检查点抑制剂联合是一种耐受性良好但迄今未充分探索的联合方案，可能为晚期肉瘤带来显著临床获益——这一发现值得在临床试验中进一步评估。
