Chemoimmunotherapy for the salvage treatment of Ewing sarcoma: A case report

Abstract

Introduction Although, immune check-point inhibitors changed the course of many cancers, the outcomes in sarcomas were rather disappointing with less than 10% response rates. Ewing sarcoma is a poorly differentiated and aggressive tumor mostly seen in the children and adolescents. It’s a distinct type of sarcoma with prominent chemosensitivity in the early stages. However, the relapsing disease has a poor prognosis with limited treatment options. Case report Herein, we represent a case of relapsed Ewing sarcoma treated with multiple lines of chemotherapy. Management & outcome: The patient had a very good response to salvage treatment with a combination of paclitaxel and nivolumab which lasted for twelve months after the cessation of treatment. Discussion We think that chemotherapy plus immunotherapy can be an option for Ewing sarcoma patients treated with multiple lines of chemotherapy.

Future Directions in the Treatment of Osteosarcoma

“…This suggests a way forward may be to combine immunotherapy with drugs which promote an immune-activating microenvironment; specifically using this precision-based approach for patients with features of low or average immune infiltration. Finally, it is indeed possible that a chemoimmunotherapy may be more effective than either alone, as suggested in a recent case report of paclitaxel and nivolumab against Ewing sarcoma [ 83 ] and a large study of patients with metastatic triple negative breast cancer treated with nab-paclitaxel an atezolizumab [ 84 ].…”

Mediastinal lymph node metastasis as a single expression of disease relapse in Ewing's sarcoma: multidisciplinary approach of two consecutive cases

“…In the immunotherapy era, there are currently in progress few clinical trials assessing checkpoint inhibitors that interrupt the repressive crosstalk between cancer and immune cells, either as a single agent or combined with conventional chemotherapy (18). Unfortunately, clinical responses in trials remain anecdotal but highlight the necessity to improve characterization of the tumor microenvironment to unlock the immunotherapeutic response (19). Despite novel therapeutic strategies for Ewing's sarcoma that include IGF-1 receptor (IGF-1R)-targeted antibodies combined with mTOR inhibitors (mTORi), as well as chemotherapy-PARP combinations, which could represent new prospects for the future, the prognosis remains poor (20,21).…”