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First report on two cases of pleomorphic dermal sarcoma successfully treated with immune checkpoint inhibitors
Sebastian Klein1,2, Oana-Diana Persa3, Cornelia Mauch3
1Institute of Pathology, University Hospital Cologne, Cologne, Germany.
Abstract:
Pleomorphic dermal sarcoma (PDS) is one of the most common sarcoma of the skin. Currently, limited treatment options exist for advanced stages of the disease. While immune checkpoint inhibitors (CPIs) have revolutionized cancer treatment options-their efficacy in PDS has not been explored yet. Here, we present two advanced PDS cases that showed response to anti-PD-1 therapy. Patient A had a locally metastasized PDS and reached a complete remission of the disease after eight cycles of Pembrolizumab. Patient B developed an inoperable relapse of PDS with a complete remission of the disease 4 months after treatment with Pembrolizumab in combination with radiotherapy. To our knowledge, this is the first report of two individuals with advanced PDS that successfully underwent anti-PD1 treatment. By comparing the immune micromilieu to a previously published cohort, we show that the two cases are representative for PDS tumors - potentially making these results more generalizable.
Insights
This study reports the first successful use of anti-PD-1 therapy, specifically Pembrolizumab, in two advanced pleomorphic dermal sarcoma (PDS) cases. Both patients achieved complete remission, suggesting potential for this immunotherapy in treating advanced PDS.
Area of Science:
- Dermatology
- Oncology
- Immunotherapy
Background:
- Pleomorphic dermal sarcoma (PDS) is a common skin sarcoma with limited treatment options for advanced stages.
- Immune checkpoint inhibitors (CPIs) have shown promise in various cancers, but their efficacy in PDS remains unexplored.
Purpose of the Study:
- To investigate the efficacy of anti-PD-1 therapy in patients with advanced pleomorphic dermal sarcoma.
- To present the first reported cases of PDS response to anti-PD-1 treatment.
Main Methods:
- Case report of two patients with advanced PDS treated with Pembrolizumab (anti-PD-1 therapy).
- Patient A received Pembrolizumab monotherapy; Patient B received Pembrolizumab combined with radiotherapy.
- Immune micromilieu analysis was performed and compared to a published cohort.
Main Results:
- Patient A achieved complete remission after eight cycles of Pembrolizumab for locally metastasized PDS.
- Patient B achieved complete remission 4 months after combination therapy (Pembrolizumab and radiotherapy) for inoperable PDS relapse.
- The analyzed immune micromilieu of the cases was representative of PDS tumors.
Conclusions:
- Anti-PD-1 therapy, such as Pembrolizumab, demonstrates potential efficacy in treating advanced pleomorphic dermal sarcoma.
- Combination therapy with radiotherapy may enhance treatment outcomes in advanced PDS.
- These findings warrant further investigation into immunotherapy for PDS, potentially offering new treatment avenues.
