Successful Sequential Multimodal Therapy for Lingual Rhabdomyosarcoma in a Young Adult: Case Report

Area of Science:

• Oncology
• Head and Neck Surgery
• Medical Genetics

Background:

• Lingual rhabdomyosarcoma (RMS) is an exceptionally rare cancer in adults, lacking established treatment protocols.
• Adult RMS presents unique challenges due to its rarity and the absence of standardized therapeutic guidelines.

Purpose of the Study:

• To report a case of adult lingual RMS managed with a sequential, multimodal treatment approach.
• To evaluate the efficacy and safety of integrating immunotherapy and antiangiogenic therapy in advanced lingual RMS.

Main Methods:

• A 19-year-old male with lingual RMS received sequential chemotherapy regimens (doxorubicin/ifosfamide, cisplatin/5-fluorouracil, vincristine/actinomycin D/cyclophosphamide with pembrolizumab).
• Subsequent treatment involved cetuximab and bevacizumab, followed by intensity-modulated radiotherapy (IMRT).

Main Results:

• Initial chemotherapy regimens led to disease progression.
• Third-line therapy (VAC + pembrolizumab) provided transient stabilization but was limited by toxicity.
• Cetuximab + bevacizumab induced a significant partial response with good tolerance.
• IMRT consolidation resulted in durable locoregional control without systemic disease.
• Swallowing and phonation functions were preserved.

Conclusions:

• Individualized, stepwise management is crucial for adult lingual RMS.
• Combining immunotherapy and antiangiogenic therapy may offer significant tumor control and functional preservation in select adult RMS cases.
• This approach highlights a potential strategy for managing rare adult malignancies.