Bartlett Edmund K, D'Angelo Sandra P, Kelly Ciara M, Siegelbaum Robert H, Fisher Charles, Antonescu Cristina R, Ariyan Charlotte E
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Department of Surgery, Weill Cornell Medical College, New York, NY, United States.
Front Oncol. 2021 Oct 15;11:725484. doi: 10.3389/fonc.2021.725484. eCollection 2021.
Treatment options for patients with advanced sarcoma remain limited. Promising responses to checkpoint inhibition have been observed, but responses to single-agent PD-1 inhibition are rare. We report on two patients with multiply recurrent myxofibrosarcoma treated with the combination of regionally administered melphalan ( isolated limb infusion) and pembrolizumab. Both patients had recurrent disease after multiple surgical resections and radiation. Analysis of primary tumors demonstrated microsatellite stable tumors with few mutations. After combination treatment, one patient had a significant partial response of 6 months duration, the second patient had a complete response of 2 years duration. Post treatment biopsies demonstrated immune infiltration into the tumor. These promising responses in patients with multiply recurrent myxofibrosarcoma have prompted the development of an investigator-initiated clinical trial to formally study the combination of regional melphalan and pembrolizumab in a systematic fashion (NCT04332874).
晚期肉瘤患者的治疗选择仍然有限。已观察到对检查点抑制有良好反应，但单药PD-1抑制的反应很少见。我们报告了两名多次复发的黏液纤维肉瘤患者，他们接受了局部应用美法仑（隔离肢体灌注）和帕博利珠单抗联合治疗。两名患者在多次手术切除和放疗后均出现复发性疾病。对原发性肿瘤的分析显示微卫星稳定肿瘤，突变很少。联合治疗后，一名患者出现持续6个月的显著部分缓解，第二名患者出现持续2年的完全缓解。治疗后活检显示肿瘤有免疫浸润。这些在多次复发的黏液纤维肉瘤患者中出现的有前景的反应促使开展一项由研究者发起的临床试验，以系统地正式研究局部美法仑和帕博利珠单抗的联合应用（NCT04332874）。
