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Case Reports
. 2019 Dec;10(12):2312-2315.
doi: 10.1111/1759-7714.13215. Epub 2019 Oct 16.

Exceptionally rapid response to pembrolizumab in a SMARCA4-deficient thoracic sarcoma overexpressing PD-L1: A case report

Kohichi Takada  1 , Shintaro Sugita  2 , Kazuyuki Murase  1 , Tomoki Kikuchi  3 , Ginji Oomori  1 , Ryo Ito  1 , Naotaka Hayasaka  1 , Koji Miyanishi  1 , Satoshi Iyama  4 , Hiroshi Ikeda  4 , Masayoshi Kobune  4 , Makoto Emori  5 , Junji Kato  1 , Tadashi Hasegawa  2
Affiliations
Case Reports

Exceptionally rapid response to pembrolizumab in a SMARCA4-deficient thoracic sarcoma overexpressing PD-L1: A case report

Kohichi Takada et al. Thorac Cancer. 2019 Dec.

Erratum in

  • CORRIGENDUM.
    [No authors listed] [No authors listed] Thorac Cancer. 2020 Dec;11(12):3645. doi: 10.1111/1759-7714.13747. Thorac Cancer. 2020. PMID: 33258562 Free PMC article. No abstract available.

Abstract

SMARCA4-deficient thoracic sarcoma (SMARCA4-DTS) is a new clinical entity characterized by SMARCA4 inactivation and has a dismal prognosis because of rapid growth. Effective treatments for SMARCA4-DTS have not yet been developed. Most recently, anti-programmed cell death 1 receptor (PD-1) blockade has been effective for SMARCA4-deficient lung cancer and malignant rhabdoid tumor-like tumors. Here, we describe a patient with SMARCA4-DTC who experienced a marked response to the administration of pembrolizumab. A 70-year-old female was referred to our department for treatment of SMARCA4-DTC. Positron emission tomography-computed tomography had revealed a left mediastinal tumor, peritoneal dissemination and multiple cutaneous metastases at diagnosis. Immunohistochemical analyses revealed 60% of tumor cells expressed programmed cell death ligand 1 (PD-L1). The patient was given pembrolizumab as first-line treatment. Pembrolizumab suppressed tumor growth dramatically, with only one dose leading to a partial response. Our case suggests the immunohistochemical analysis of PD-L1 expression be undertaken for patients with SMARCA4-DTS and that pembrolizumab treatment may be a promising strategy for PD-L1-positive SMARCA4-DTS.

Keywords: PD-L1; SMARCA4-deficient thoracic sarcoma; pembrolizumab.

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Figures

Figure 1
Figure 1
PET‐CT and follow‐up CT images. Arrows indicate tumors. (a) Pretreatment positron emission tomography (PET)‐computed tomography (CT) scan of the patient. (b) Pretreatment CT scan. (c) CT scan after one dose of pembrolizumab. (d) CT scan after eight doses of pembrolizumab.
Figure 2
Figure 2
Microscopic findings in a resected tumor. Scale bars 100 μm. (a) Hematoxylin and eosin (H&E) staining. (b) SMARCA2 (INI1) staining. (c) SMARCA4 (BRG1) staining. (d) Programmed cell death ligand 1 (PD‐L1) staining. (e) CD4 staining. (f) CD8 staining.
See this image and copyright information in PMC

Comment in

References

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