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CASE REPORT article

Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1518775

Long-Term Disease Control in Dedifferentiated Liposarcoma: A Case Report on Trabectedin Priming Followed by PD-1 Inhibition

Provisionally accepted
Johannes M. Waldschmidt Johannes M. Waldschmidt 1*Lukas Haug Lukas Haug 2Christine Riedhammer Christine Riedhammer 1Christoph K. W. Deinzer Christoph K. W. Deinzer 3Marcus Zimmermann Marcus Zimmermann 4Anke Heidemeier Anke Heidemeier 5Anne Hendricks Anne Hendricks 6Andreas Rosenwald Andreas Rosenwald 2Hermann Einsele Hermann Einsele 1Peter Reichardt Peter Reichardt 7Volker Kunzmann Volker Kunzmann 1Armin Wiegering Armin Wiegering 6Daniel Pink Daniel Pink 8,9Martin K. Kortüm Martin K. Kortüm 1
  • 1 Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
  • 2 Department of Pathology, University Hospital Würzburg, Würzburg, Germany
  • 3 Department of Internal Medicine VIII, University Hospital Tübingen, Tübingen, Germany
  • 4 Department of Radiation Therapy, University Hospital Würzburg, Würzburg, Germany
  • 5 Department of Radiology, University Hospital Würzburg, Würzburg, Germany
  • 6 Department of Visceral Surgery, University Hospital Würzburg, Würzburg, Germany
  • 7 Department of Oncology, Helios Clinic Berlin-Buch, Berlin, Berlin, Germany
  • 8 Department of Oncology, Helios Clinic Bad Saarow, Bad Saarow, Germany
  • 9 Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany

The final, formatted version of the article will be published soon.

    Background: Dedifferentiated liposarcoma (DDLPS) is a rare mesenchymal cancer originating from the adipose tissue, with poor survival rates for most patients, highlighting the critical need for novel treatment options.Case Description: This report examines the efficacy and safety of sequential pre-treatment with the marine-derived alkaloid trabectedin followed by checkpoint inhibition using the anti-PD-1 antibody nivolumab in a 63-year-old male patient with unresectable retroperitoneal DDLPS. Treatment was initiated at the time of the seventh relapse as part of the NitraSarc phase 2 multicenter trial for inoperable soft tissue sarcoma conducted by the German Interdisciplinary Sarcoma Group (GISG-15, NCT03590210). The patient demonstrated an immediate tumor response, and in combination with minor surgery, achieved R0 resection status, which was subsequently maintained without the need for further therapy for the past 52 months. Correlative molecular analyses revealed a sustained DNA damage repair machinery and downregulation of PD-1 protein expression in post-treatment tumor samples.This report provides exemplary insight on the feasibility and efficacy of sequential pre-treatment with trabectedin as a priming strategy for PD-1 inhibition in advanced DDLPS.Full trial results from NitraSarc are pending for publication.

    Keywords: Sarcoma, Dedifferentiated liposarcoma, checkpoint inhibition, PD-1, immune microenvironment

    Received: 28 Oct 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Waldschmidt, Haug, Riedhammer, Deinzer, Zimmermann, Heidemeier, Hendricks, Rosenwald, Einsele, Reichardt, Kunzmann, Wiegering, Pink and Kortüm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Johannes M. Waldschmidt, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany

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