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. 2025 Apr 30:16:1567736.
doi: 10.3389/fimmu.2025.1567736. eCollection 2025.

Dedifferentiated liposarcomas treated with immune checkpoint blockade: the MD Anderson experience

Madeline B Torres  1   2 , Cheuk Hong Leung  3 , Marianne Zoghbi  4 , Rossana Lazcano  5 , Davis Ingram  5 , Khalida Wani  5 , Emily Z Keung  1 , M Alejandra Zarzour  4 , Christopher P Scally  1 , Kelly K Hunt  1 , Anthony Conley  4 , Andrew J Bishop  6 , B Ashleigh Guadagnolo  6 , Ahsan Farooqi  6 , Devarati Mitra  6 , Alison K Yoder  6 , Michael S Nakazawa  4 , Dejka Araujo  4 , Andrew Livingston  4 , Ravin Ratan  4 , Shreyaskumar Patel  4 , Vinod Ravi  4 , Alexander J Lazar  5   7 , Christina L Roland  1 , Neeta Somaiah  4 , Elise F Nassif Haddad  4   8
Affiliations

Dedifferentiated liposarcomas treated with immune checkpoint blockade: the MD Anderson experience

Madeline B Torres et al. Front Immunol. .

Abstract

Background: Dedifferentiated liposarcoma (DDLPS) is one of the most common types of soft tissue sarcoma (STS) characterized by liposarcomatous differentiation and a predilection for the retroperitoneum. Despite the growing number of histology-specific immune checkpoint blockade (ICB) trials in STS, it is still difficult to identify the radiographic objective response rate (ORR) for DDLPS in the real world setting. This study aimed to evaluate the ORR and survival of patients with DDLPS treated with ICB at a single center.

Methods: We conducted a retrospective study of 31 patients with pathologically confirmed DDLPS treated with ICB at MD Anderson Cancer Center between 2018 and 2023. Patient demographics, disease characteristics, treatment history, and response to ICB were analyzed. Immunohistochemical analysis was performed on tumor samples to assess immune-related markers.

Results: ORR by RECIST 1.1 was 3.2% (n=1/31). Among all patients (n=31), 6% achieved partial radiographic response, while 39% had stable disease, and 55% showed progressive disease. Median progression-free survival (PFS) was 3.5 (95%CI:1.9, 4.7) months, and overall survival (OS) after ICB initiation was 19.7 (95%CI: 8.8, not reached) months. Patients without prior systemic therapy demonstrated better OS (p=0.004). Immunohistochemistry revealed no relationship between pre- or post-ICB expression of CD8, CD20, CD21 and PDL-1 and response.

Conclusion: While the response to ICB in DDLPS remains limited, specific immune markers may influence treatment outcomes. CD20/21 post-ICB appear more important for prognosis. Further research is warranted to identify predictive factors for ICB efficacy in DDLPS.

Keywords: Anti-PD1; dedifferentiated liposarcoma; immune-checkpoint inhibitors; immunotherapy; sarcoma; survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Waterfall plot demonstrating best response measurement. PD, progressive disease; PR, partial response; SD, stable disease.
Figure 2
Figure 2
Progression free survival by number of best response. PFS, Progression free survival; PR, partial response; SD, stable disease; NC, not calculable.
Figure 3
Figure 3
Overall survival since diagnosis.
Figure 4
Figure 4
Overall survival (OSICB) by number of prior lines of systemic therapy. OSICB is defined as start from immune checkpoint blocker to death or last follow-up.
Figure 5
Figure 5
Overall survival by best response. Overall survival is defined as start from immune checkpoint blocker to death or last follow-up. NC, not calculable; OS, overall survival; PD, progressive disease; PR, partial response; SD, stable disease.
See this image and copyright information in PMC

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