Cancers (May 2024)

High-Grade Pleomorphic Sarcomas Treated with Immune Checkpoint Blockade: The MD Anderson Cancer Center Experience

  • Lewis F. Nasr,
  • Marianne Zoghbi,
  • Rossana Lazcano,
  • Michael Nakazawa,
  • Andrew J. Bishop,
  • Ahsan Farooqi,
  • Devarati Mitra,
  • Beverly Ashleigh Guadagnolo,
  • Robert Benjamin,
  • Shreyaskumar Patel,
  • Vinod Ravi,
  • Dejka M. Araujo,
  • Andrew Livingston,
  • Maria A. Zarzour,
  • Anthony P. Conley,
  • Ravin Ratan,
  • Neeta Somaiah,
  • Alexander J. Lazar,
  • Christina Roland,
  • Emily Z. Keung,
  • Elise F. Nassif Haddad

DOI
https://doi.org/10.3390/cancers16091763
Journal volume & issue
Vol. 16, no. 9
p. 1763

Abstract

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Background: Undifferentiated pleomorphic sarcomas (UPSs) are amongst the most common subtypes of soft-tissue sarcomas. Few real-world data on the use of immune checkpoint blockade (ICB) in UPS patients and other high-grade pleomorphic STS patients are available. Purpose: The purpose of our study is to describe the efficacy and toxicity of ICB in patients with advanced UPSs and other high-grade pleomorphic sarcomas treated at our institution. Methods: This is a retrospective, observational study of all patients with metastatic high-grade pleomorphic sarcomas treated with FDA-approved ICB at MD Anderson Cancer Center between 1 January 2015 and 1 January 2023. Patients included in trials for which results are not yet published were excluded. Results: Thirty-six patients with advanced/metastatic pleomorphic sarcomas were included. The median age was 52 years. A total of 26 patients (72%) had UPSs and 10 patients (28%) had other high-grade pleomorphic sarcomas. The median follow-up time was 8.8 months. The median PFS was 2.9 months. The 3-month PFS and 6-month PFS were 46% and 32%, respectively. The median OS was 12.9 months. The 12-month OS and 24-month OS were 53% and 29%, respectively. The best response, previous RT, and type of ICB treatment were significantly and independently associated with shorter PFS (p = 0.0012, p = 0.0019 and p = 0.036, respectively). No new safety signal was identified, and the toxicity was overall manageable with no toxic deaths and only four patients (11%) stopping treatment due to toxicity. Conclusions: Real-world retrospective data are consistent with the published literature, with a promising 6-month PFS of 32%. Partial or stable responders to ICB treatment have significantly improved PFS compared to progressors.

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