Abstract:
Patients with undifferentiated pleomorphic sarcoma (UPS) of soft tissue have responsiveness to immunotherapy treatment. Since few patients with soft tissue sarcoma respond to immunotherapy, guidelines for its management are lacking. Specifically, the optimal duration of immunotherapy is unclear. This report is unique owing to the probable longest reporting of successful continuous immunotherapy for metastatic UPS over 6.5 years and 109 cycles. Here a patient who developed metastatic UPS is presented. The patient required systemic therapy for metastatic sarcoma, eventually with immunotherapy. A prolonged treatment over many years is elaborated. A robust response was seen but occasionally augmented by adding external beam radiation therapy (XRT). Treatment was tolerated without adverse effects. A brief review of current treatment practice and known risks of prolonged immunotherapy is presented. For similar patients, a lengthy treatment course, beyond that utilized for other malignancies, can be considered. This is likely to be safe if it is tolerated and without early adverse effects. Other treatment modalities such as palliative surgery and XRT are described which may also be required for management of mixed responses.
摘要:
软组织未分化多形性肉瘤(UPS)患者对免疫治疗具有反应性。由于很少有软组织肉瘤患者对免疫疗法有反应,缺乏管理准则。具体来说,免疫治疗的最佳持续时间尚不清楚.该报告是独特的,因为对于超过6.5年和109个周期的转移性UPS的成功连续免疫疗法的报告可能最长。这里介绍了发生转移性UPS的患者。患者需要全身性治疗转移性肉瘤,最终免疫疗法。详细说明了多年的长期治疗。观察到稳健的反应,但偶尔通过增加外部束放射治疗(XRT)来增强。治疗耐受,无不良反应。简要介绍了当前的治疗实践和长期免疫疗法的已知风险。对于类似的患者,一个漫长的疗程,除了用于其他恶性肿瘤之外,可以考虑。如果耐受并且没有早期不良反应,这可能是安全的。描述了其他治疗方式,例如姑息性手术和XRT,这也可能是管理混合反应所必需的。