Complete Response to Dual Immunotherapy in a Young Adult with Metastatic Alveolar Soft Part Sarcoma Enabled by a Drug Recovery Program in a Community Practice
| Autor: | Amy Adams, Alexandra Conry, Howland E. Crosswell, Robert D. Siegel, Alfred W Campbell, Daniel B Fried, James D. Bearden, Melissa Peters |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Oncology Drug medicine.medical_specialty medicine.medical_treatment media_common.quotation_subject 03 medical and health sciences 0302 clinical medicine Residence Characteristics Internal medicine Metastatic Alveolar Soft Part Sarcoma Alveolar soft part sarcoma Humans Medicine 030212 general & internal medicine Young adult Complete response media_common business.industry Immunotherapy RELAPSED DISEASE medicine.disease humanities Sarcoma Alveolar Soft Part 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Community practice Female business |
| Zdroj: | Journal of Adolescent and Young Adult Oncology. 9:449-452 |
| ISSN: | 2156-535X 2156-5333 |
| Popis: | Alveolar soft part sarcoma (ASPS) is an extremely rare tumor that frequently occurs in adolescent and young adults (AYA). Survival is poor for patients with metastatic and/or relapsed disease not amenable to local control, and limited therapeutic options are available. A major barrier to cancer care in the United States AYA population is lack of access to coordinated care and appropriate therapies for those who lack insurance or who are underinsured. We report a 25-year-old unemployed, uninsured, single mother who presented with a 12.8 × 21 cm soft tissue thigh mass with heterogeneous avidity, max standardized uptake value of 9, with metastatic disease to the ipsilateral inguinal lymph nodes and to the bilateral lungs. After local control of the primary mass was obtained, a recently developed, comprehensive drug replacement program (DRP) was used to gain access to nivolumab, and after frank progression was noted, ipilimumab was added every 6 weeks. No biomarkers associated with response to immunotherapy were identified. After four cycles, a complete response was observed and patient remains disease free 36 months after beginning dual immunotherapy treatment. We obtained immunotherapy agents through a DRP and describe the development and the utility of this program in the community setting. Our report highlights both first documented sustained complete response to sequenced immunotherapy in an AYA with ASPS as well as a comprehensive DRP, which enabled access to therapy for our patient. |
| Databáze: | OpenAIRE |
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