Abstract
Simple SummarySoft tissue and bone sarcomas is a very heterogeneous group of tumors that has an aggressive course, especially in the metastatic setting. In this group the therapeutic options are rather limited. Immunotherapy is nowadays used successfully for the treatment of various tumor types. However in sarcomas this is still not the case. In this review article we aim to present all the available published information from clinical trials about the results of using immune checkpoint blockade as a therapeutic agent in sarcomas. Moreover, we try to unravel the possible prognostic biomarkers that may play here an important role.Soft tissue and bone sarcomas are a very heterogeneous group of tumors with many subtypes for which diagnosis and treatment remains a very challenging task. On top of that, the treatment choices are limited, and the prognosis of aggressive sarcomas remains poor. Immune checkpoint inhibitors (ICIs) have drawn a lot of attention last years because of their promising response rates and their durable effects. ICIs are currently widely used in the daily routine practice for the treatment of a different malignancies, such as melanoma, Hodgkin lymphoma, and non-small cell lung carcinoma. Still, ICIs are not included in the standard treatment protocols of the different sarcoma types. However, a plethora of clinical trials investigates the clinical benefit of ICIs in sarcomas. There is clear need to develop predictive biomarkers to determine which sarcoma patients are most likely to benefit from immune checkpoint blockade. This review will focus on (i) the clinical trial results on the use of ICIs in different sarcoma types; and on (ii) possible biomarkers predictive for the effectiveness of these drugs in sarcomas.
Highlights
Soft tissue and bone sarcomas are very rare neoplasms and account for less than1% [1,2,3] of all malignancies
Pembrolizumab was used as monotherapy and was administered at 200 mg intravenously every three weeks for both groups, until disease progression or unacceptable toxicity
The clinical trials described in this review do not reach a common conclusion or provide strong evidence for the use of any kind of immunotherapy
Summary
Soft tissue and bone sarcomas are very rare neoplasms and account for less than. 1% [1,2,3] of all malignancies. We refer to mesenchymal tumors as an entity, there are more than 200 distinct categories recognized and described in the latest World. Health Organization classification of tumors book [4]. The rarity of these tumors leads in to difficulties defining the right criteria for diagnosis and precise treatment. Many different parameters have been investigated in order to establish prognostic criteria for sarcomas. The tumor grade has been proven to be one of the best predictors of metastatic risk and progression free survival [5]
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