Rapid and Complete Response to Combination Anti-CTLA-4 and Anti-PD-1 Checkpoint Inhibitor Therapy in a Patient With Stage IV Refractory End-stage Epithelioid Sarcoma: A Case Report
| Autor: | Steven L. Halpern, David Panush, Elli G Paleoudis, Melinda Weber, Francis Patterson, Andrew Pecora, Jeffery Toretsky |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Epithelioid sarcoma Programmed Cell Death 1 Receptor Immunology Ipilimumab Young Adult 03 medical and health sciences 0302 clinical medicine Refractory Internal medicine Biomarkers Tumor medicine Humans Immunology and Allergy CTLA-4 Antigen Enhancer of Zeste Homolog 2 Protein Stage (cooking) Immune Checkpoint Inhibitors Neoplasm Staging Pharmacology Performance status medicine.diagnostic_test business.industry Sarcoma SMARCB1 Protein medicine.disease Treatment Outcome 030104 developmental biology Prior Therapy Positron emission tomography 030220 oncology & carcinogenesis Nivolumab business medicine.drug |
| Zdroj: | Journal of Immunotherapy. 43:286-290 |
| ISSN: | 1524-9557 |
| DOI: | 10.1097/cji.0000000000000332 |
| Popis: | Epithelioid sarcoma, in the relapse-refractory setting, has limited expected survival. SMARCB1 inactivation, common in epithelioid sarcoma, causes loss of INI1 protein expression and overexpression of the cancer cell growth promoting methyltransferase enzyme, EZH2. We treated a 19-year-old male with stage IV SMARCB1 inactivated epithelioid sarcoma presenting with recurrent end stage (Eastern Cooperative Oncology Group Performance Status 4) rapidly progressing bulky disease with combination ipilimumab and nivolumab. He failed standard therapy and an EZH2 inhibitor (tazemetostat). He presented (May 13, 2019) with a large (16.1×18.6 cm) soft tissue back mass extending from T10 to L3. Complete clinical regression of the back mass occurred within 2 weeks (May 28, 2019) of cycle 1 of combined checkpoint inhibition therapy followed by a positron emission tomography-negative complete remission (October 11, 2019). After a second negative positron emission tomography/computed tomography scan (January 13, 2020), checkpoint inhibition therapy was discontinued. He has returned to normal activities with a normal physical examination and Eastern Cooperative Oncology Group Performance Status of 0 at his last visit (June 29, 2020). In conclusion, combined checkpoint inhibition therapy warrants further study in the salvage setting in patients with epithelioid and other INI1 protein-deficient sarcomas seemingly regardless of prior therapy, extent of disease, and performance status. |
| Databáze: | OpenAIRE |
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