Dr. Roland on Findings From a Phase 2 Study With Neoadjuvant Checkpoint Blockade in Sarcoma

Christina L. Roland, MD, MS, FACS, chief of Sarcoma Surgery and an assistant professor in the Department of Surgical Oncology in the Division of Surgery, as well as the associate medical director of the Sarcoma Center at The University of Texas MD Anderson Cancer Center, discusses the results from a phase 2 study (NCT03307616) evaluating neoadjuvant checkpoint blockade study in patients with undifferentiated pleomorphic sarcoma (UPS) and dedifferentiated liposarcoma (DDLPS).

Twenty-three patients were determined to be evaluable and data for them were reported in a presentation delivered atthe 2020 ASCO Virtual Scientific Meeting; 4 additional patients have been treated but they did not have sufficient data to report at the time of the presentation, explains Roland. A total of 14 patients had DDLPS and 9 patients had UPS were then randomized. The most exciting findings are in the UPS arm, according to Roland.

In patients with UPS, no difference between nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy), except more toxicity was reported in the doublet arm, Roland adds. In terms of efficacy, the majority of patients had less than 15% of residual viable tumor on their surgical specimen. Historical data were examined before the study was designed to determine whether there was a median for either radiation or chemoradiation alone. The median for the amount of hyalinization for radiation was 5% to 10%. In the study presented at the ASCO Annual Meeting, the median was 93% in patients with UPS. Although a radiation-alone group was not included in the trial, by using historical cohorts, it may be deduced that the amount of hyalinization in patients with UPS is better than what has been seen previously, concludes Roland.