Metastatic Myxofibrosarcoma with Durable Response to Temozolomide Followed by Atezolizumab: A Case Report.
Antineoplastic drug resistance
Immunotherapy
Soft tissue sarcoma
Temozolomide
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
04
01
2021
accepted:
01
02
2021
pubmed:
18
2
2021
medline:
13
7
2021
entrez:
17
2
2021
Statut:
ppublish
Résumé
Myxofibrosarcoma (MFS) is a well-recognized histotype of soft tissue sarcomas that generally presents with localized disease. Herein, we describe the case of a patient with metastatic MFS who experienced durable response to sixth-line therapy with temozolomide. Upon further progression, his tumor was notable for a high tumor mutational burden, and he was subsequently treated with seventh-line immunotherapy, atezolizumab, achieving a second durable response. This case highlights the role of immunotherapy after administration of alkylating agents. Review of the literature indicates that recurrent tumors treated with alkylating agents often experience hypermutation as a means of developing resistance and that checkpoint inhibitors are subsequently effective in these tumors. KEY POINTS: To the authors' knowledge, this is the first report of a patient with myxofibrosarcoma with high tumor mutational burden after administration of temozolomide monotherapy. Hypermutation may be a resistance mechanism for patients with soft tissue sarcoma who develop resistance to alkylating agents. Checkpoint inhibition may be effective therapy in patients with soft tissue sarcoma with high tumor mutational burden as a consequence of alternate systemic therapy resistance.
Identifiants
pubmed: 33594725
doi: 10.1002/onco.13728
pmc: PMC8265341
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
atezolizumab
52CMI0WC3Y
Temozolomide
YF1K15M17Y
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
549-553Informations de copyright
© 2021 AlphaMed Press.
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