Durable response for ASPS
tumor, xerostomia, thoracolumbar, necrotic, abscess, constipation, pain, sternal manubrium mass, hip pain, tenderness, ASPS
DISEASE PROGRESSION, ALVEOLAR SOFT PART SARCOMA, APPENDICEAL ABSCESS, TUMOR, LIVER METASTASES, XEROSTOMIA, ADVERSE EVENTS, BONE METASTASIS, GINGIVAL BLEEDING, NECROTIC, ABSCESS, MAY, PULMONARY METASTASES, ADVERSE EVENT, HYPERTRIGLYCERIDEMIA, METASTASES
We observed two objective responses in the ASPS group with durable therapeutic effects. A 33-year-old woman presented with a left thigh mass in December 2019. The patient underwent a wide resection of the local lesion and was pathologically diagnosed with ASPS. Chest computed tomography (CT) revealed multiple metastases (more than 10 lesions with a maximum diameter of > 4 cm) in May 2021. She then received triprimab (anti-PD-1 antibody) 240 mg intravenous fusion once every 3 weeks and showed disease progression in January 2022, with the best clinical evaluation of SD. She was then administered a combination of anlotinib (an anti-angiogenesis TKIs domestically made in China) and tislelizumab (another anti-PD-1 antibody) 200 mg once every 3 weeks beginning January 5, 2022. However, in June 2022, chest CT revealed slow progression of two tiny lesions in her lungs, while she developed perforation of the appendix and abscess formation. After conservative treatment of the appendiceal abscess, she was enrolled on July 13, 2022, and received TQB2858 on July 14, 2022. After four cycles of TQB2858 infusion, her chest CT showed PR (Fig. Radiological changes for the patient (PR) with metastatic alveolar soft part sarcoma. IHC staining of tumor biospecimens. The second patient was a 31-year-old male worker who presented with a sternal manubrium mass and tenderness. Chest CT revealed a necrotic manubrium sternum with the formation of a soft tissue mass. More importantly, multiple pulmonary metastases were found. Positron emission tomography-computed tomography also demonstrated liver metastases. Subsequent puncture histopathology with hematoxylin and eosin and IHC staining confirmed the diagnosis of ASPS. He did not receive any operative or radioactive treatment before starting oral traditional Chinese medicine three times daily from August 2021. Without any evaluation of the tumor response, the treatment was stopped in May 2022. In June 2022, thoracolumbar enhanced magnetic resonance imaging (MRI) indicated bone metastasis to the sacrum and L4 and T10 vertebrae. He was then switched to anlotinib 120 mg once every 3 weeks from June 24, 2022, for three cycles. However, re-examination with enhanced chest CT and thoracolumbar MRI in August 2022 revealed multiple metastases to the bones, lungs, liver, and subcutaneous soft tissue of the right hip. He was then enrolled on September 15, 2022, and received TQB2858 on September 19, 2022. After three cycles infusion of TQB2858, enhanced CT revealed PR. As of April 2023, the patient’s target lesions were evaluated as a PR. His major adverse events were elevation of alanine aminotransferase, aspartate aminotransferase, hemobilirubin, blood lactate dehydrogenase, and D-dimer levels. Other adverse events included hypertriglyceridemia, gingival bleeding, xerostomia, constipation, and hip pain. The most severe adverse event was hip pain (grade 3).