Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment
Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezo...
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| Published in | Radiology case reports Vol. 13; no. 4; pp. 882 - 885 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
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Netherlands
Elsevier
01.08.2018
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| Abstract | Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezolizumab), a monoclonal anti-programmed death ligand-1 antibody. Imaging results for the patient suggested disease progression of multiple brain metastases with stable systemic disease. The patient met response evaluation criteria in solid tumors (RECIST) criteria of progression of disease and was removed from treatment with MPDL3280. Subsequent surgical resection of the brain lesions revealed nonviable tumor with extensive lymphocytic infiltrates consistent with pseudoprogression. This case report adds to a growing number of reports that question reliance on RECIST criteria and suggest need for further refinement of RECIST or irRECIST during immune checkpoint inhibitor treatment for central nervous system metastatic lesions. |
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| AbstractList | Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezolizumab), a monoclonal anti-programmed death ligand-1 antibody. Imaging results for the patient suggested disease progression of multiple brain metastases with stable systemic disease. The patient met response evaluation criteria in solid tumors (RECIST) criteria of progression of disease and was removed from treatment with MPDL3280. Subsequent surgical resection of the brain lesions revealed nonviable tumor with extensive lymphocytic infiltrates consistent with pseudoprogression. This case report adds to a growing number of reports that question reliance on RECIST criteria and suggest need for further refinement of RECIST or irRECIST during immune checkpoint inhibitor treatment for central nervous system metastatic lesions. Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezolizumab), a monoclonal anti-programmed death ligand-1 antibody. Imaging results for the patient suggested disease progression of multiple brain metastases with stable systemic disease. The patient met response evaluation criteria in solid tumors (RECIST) criteria of progression of disease and was removed from treatment with MPDL3280. Subsequent surgical resection of the brain lesions revealed nonviable tumor with extensive lymphocytic infiltrates consistent with pseudoprogression. This case report adds to a growing number of reports that question reliance on RECIST criteria and suggest need for further refinement of RECIST or irRECIST during immune checkpoint inhibitor treatment for central nervous system metastatic lesions. Keywords: Pseudoprogression, PDL1, Alveolar soft part sarcoma |
| Author | Franz, Carl Thakur, Meghna Das Pollock, Jeffery M Davis, Lara E Vander Jagt, Thomas A |
| AuthorAffiliation | b Department of Pediatric Hematology and Oncology; Knight Cancer Institute Division of Hematology and Medical Oncology, Oregon Health Science University, Portland, OR, USA c Division of Oncology Biomarker Development, Genetech, South San Francisco, CA, USA d Division of Chemistry and Biology, Lake Tahoe Community College, South Lake Tahoe, CA, USA a Department of Radiology, Oregon Health Science University, Portland, OR, USA |
| AuthorAffiliation_xml | – name: b Department of Pediatric Hematology and Oncology; Knight Cancer Institute Division of Hematology and Medical Oncology, Oregon Health Science University, Portland, OR, USA – name: a Department of Radiology, Oregon Health Science University, Portland, OR, USA – name: d Division of Chemistry and Biology, Lake Tahoe Community College, South Lake Tahoe, CA, USA – name: c Division of Oncology Biomarker Development, Genetech, South San Francisco, CA, USA |
| Author_xml | – sequence: 1 givenname: Thomas A surname: Vander Jagt fullname: Vander Jagt, Thomas A organization: Department of Radiology, Oregon Health Science University, Portland, OR, USA – sequence: 2 givenname: Lara E surname: Davis fullname: Davis, Lara E organization: Division of Oncology Biomarker Development, Genetech, South San Francisco, CA, USA – sequence: 3 givenname: Meghna Das surname: Thakur fullname: Thakur, Meghna Das organization: Division of Oncology Biomarker Development, Genetech, South San Francisco, CA, USA – sequence: 4 givenname: Carl surname: Franz fullname: Franz, Carl organization: Division of Chemistry and Biology, Lake Tahoe Community College, South Lake Tahoe, CA, USA – sequence: 5 givenname: Jeffery M surname: Pollock fullname: Pollock, Jeffery M organization: Department of Radiology, Oregon Health Science University, Portland, OR, USA |
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| Keywords | PDL1 Pseudoprogression Alveolar soft part sarcoma |
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| Title | Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment |
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