Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma
Abstract Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use o...
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| Veröffentlicht in: | Case reports in oncology 2024-01, Vol.17 (1), p.906-912 |
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| creator | Rieth, John M. Belzer, Alex C. Walhof, Mackenzie L. Milhem, Mohammed M. |
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Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use of pembrolizumab plus pharmacologic ascorbate in 3 patients with metastatic LMS. All cases resulted in persistent objective responses and disease control significantly better than has been reported with chemotherapy or other immunotherapeutic approaches. Three patients with metastatic LMS, one each of uterine, vascular, and soft tissue origin, were treated with pembrolizumab plus pharmacologic ascorbate. The patient with uterine LMS received combination therapy at presentation and had persistent response for 12 months, which is ongoing. The patient with metastatic LMS of the inferior vena cava received combination therapy at presentation and had persistent response for 12 months, at which time new metastases were found. The patient with soft tissue LMS had disease progression on pembrolizumab monotherapy prior to the addition of ascorbate, after which she had a 17-month response, which is ongoing. No side effects attributed to treatment were reported. Conclusion: Pembrolizumab plus pharmacologic ascorbate is a novel immunotherapeutic approach and warrants further study in LMS. |
| doi_str_mv | 10.1159/000539979 |
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Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use of pembrolizumab plus pharmacologic ascorbate in 3 patients with metastatic LMS. All cases resulted in persistent objective responses and disease control significantly better than has been reported with chemotherapy or other immunotherapeutic approaches. Three patients with metastatic LMS, one each of uterine, vascular, and soft tissue origin, were treated with pembrolizumab plus pharmacologic ascorbate. The patient with uterine LMS received combination therapy at presentation and had persistent response for 12 months, which is ongoing. The patient with metastatic LMS of the inferior vena cava received combination therapy at presentation and had persistent response for 12 months, at which time new metastases were found. The patient with soft tissue LMS had disease progression on pembrolizumab monotherapy prior to the addition of ascorbate, after which she had a 17-month response, which is ongoing. No side effects attributed to treatment were reported. Conclusion: Pembrolizumab plus pharmacologic ascorbate is a novel immunotherapeutic approach and warrants further study in LMS.</description><identifier>ISSN: 1662-6575</identifier><identifier>EISSN: 1662-6575</identifier><identifier>DOI: 10.1159/000539979</identifier><identifier>PMID: 39474533</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Abdomen ; ascorbate ; Biopsy ; Cancer ; Case Report ; Cell death ; Estrogens ; Hysterectomy ; immune checkpoint inhibitors ; Immunohistochemistry ; Immunotherapy ; leiomyosarcoma ; Ligands ; Medical history ; Medical imaging ; Medical prognosis ; Metastasis ; Oophorectomy ; pembrolizumab ; programmed death 1 ; Radiation ; Sarcoma ; soft tissue sarcoma ; Vitamin C</subject><ispartof>Case reports in oncology, 2024-01, Vol.17 (1), p.906-912</ispartof><rights>2024 The Author(s). Published by S. Karger AG, Basel</rights><rights>2024 The Author(s). Published by S. Karger AG, Basel.</rights><rights>2024 The Author(s). Published by S. Karger AG, Basel. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><rights>2024 The Author(s). Published by S. Karger AG, Basel 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521403/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521403/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27635,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39474533$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rieth, John M.</creatorcontrib><creatorcontrib>Belzer, Alex C.</creatorcontrib><creatorcontrib>Walhof, Mackenzie L.</creatorcontrib><creatorcontrib>Milhem, Mohammed M.</creatorcontrib><title>Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma</title><title>Case reports in oncology</title><addtitle>Case Rep Oncol</addtitle><description>Abstract
Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use of pembrolizumab plus pharmacologic ascorbate in 3 patients with metastatic LMS. All cases resulted in persistent objective responses and disease control significantly better than has been reported with chemotherapy or other immunotherapeutic approaches. Three patients with metastatic LMS, one each of uterine, vascular, and soft tissue origin, were treated with pembrolizumab plus pharmacologic ascorbate. The patient with uterine LMS received combination therapy at presentation and had persistent response for 12 months, which is ongoing. The patient with metastatic LMS of the inferior vena cava received combination therapy at presentation and had persistent response for 12 months, at which time new metastases were found. The patient with soft tissue LMS had disease progression on pembrolizumab monotherapy prior to the addition of ascorbate, after which she had a 17-month response, which is ongoing. No side effects attributed to treatment were reported. Conclusion: Pembrolizumab plus pharmacologic ascorbate is a novel immunotherapeutic approach and warrants further study in LMS.</description><subject>Abdomen</subject><subject>ascorbate</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Case Report</subject><subject>Cell death</subject><subject>Estrogens</subject><subject>Hysterectomy</subject><subject>immune checkpoint inhibitors</subject><subject>Immunohistochemistry</subject><subject>Immunotherapy</subject><subject>leiomyosarcoma</subject><subject>Ligands</subject><subject>Medical history</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Oophorectomy</subject><subject>pembrolizumab</subject><subject>programmed death 1</subject><subject>Radiation</subject><subject>Sarcoma</subject><subject>soft tissue sarcoma</subject><subject>Vitamin C</subject><issn>1662-6575</issn><issn>1662-6575</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNpdkktv1DAQgCMEoqVw4I5QpF64LNgeO45PqFrxqLSoFSpna-JMdrPE8WInSOXXY0gpbeXDWPanbx52Ubzk7C3nyrxjjCkwRptHxTGvKrGqlFaP7-yPimcp7RmrjKrU0-IIjNRSARwXXy7JNzEM_a_ZY1MehjmVlzuMHl0YwrZ35VlyITY4UdmP5bSj8ioSTp7GqQxduaE--OuQMLrg8XnxpMMh0YubeFJ8-_jhav15tbn4dL4-26xa0GpaKSlaqUjIlvHGAWtBYO5BqkpKqHnDyEElO6eF1kS8BnRNDR1jLkcOCCfF-eJtA-7tIfYe47UN2Nu_ByFuLcapdwNZQFZR7Yx0OZ8jXVMWm0ZKoaCWoLPr_eI6zI2n1uXGIg73pPdvxn5nt-GnzaMXXDLIhjc3hhh-zJQm6_vkaBhwpDAnC1yICoCJP8lOH6D7MMcxzypTeTFuuMjU67sl3dby79ky8GoBvmPcUrwFll_wP8uD6_XXi4Wwh7aD3xNYrTU</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Rieth, John M.</creator><creator>Belzer, Alex C.</creator><creator>Walhof, Mackenzie L.</creator><creator>Milhem, Mohammed M.</creator><general>S. Karger AG</general><general>Karger Publishers</general><scope>M--</scope><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20240101</creationdate><title>Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma</title><author>Rieth, John M. ; Belzer, Alex C. ; Walhof, Mackenzie L. ; Milhem, Mohammed M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d375t-542d45e24d01bc30d32a00045644381b0ec364fc7277ee183acb83f00ccb813a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdomen</topic><topic>ascorbate</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Case Report</topic><topic>Cell death</topic><topic>Estrogens</topic><topic>Hysterectomy</topic><topic>immune checkpoint inhibitors</topic><topic>Immunohistochemistry</topic><topic>Immunotherapy</topic><topic>leiomyosarcoma</topic><topic>Ligands</topic><topic>Medical history</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Oophorectomy</topic><topic>pembrolizumab</topic><topic>programmed death 1</topic><topic>Radiation</topic><topic>Sarcoma</topic><topic>soft tissue sarcoma</topic><topic>Vitamin C</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rieth, John M.</creatorcontrib><creatorcontrib>Belzer, Alex C.</creatorcontrib><creatorcontrib>Walhof, Mackenzie L.</creatorcontrib><creatorcontrib>Milhem, Mohammed M.</creatorcontrib><collection>Karger Open Access Journals</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Case reports in oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rieth, John M.</au><au>Belzer, Alex C.</au><au>Walhof, Mackenzie L.</au><au>Milhem, Mohammed M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma</atitle><jtitle>Case reports in oncology</jtitle><addtitle>Case Rep Oncol</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>17</volume><issue>1</issue><spage>906</spage><epage>912</epage><pages>906-912</pages><issn>1662-6575</issn><eissn>1662-6575</eissn><abstract>Abstract
Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use of pembrolizumab plus pharmacologic ascorbate in 3 patients with metastatic LMS. All cases resulted in persistent objective responses and disease control significantly better than has been reported with chemotherapy or other immunotherapeutic approaches. Three patients with metastatic LMS, one each of uterine, vascular, and soft tissue origin, were treated with pembrolizumab plus pharmacologic ascorbate. The patient with uterine LMS received combination therapy at presentation and had persistent response for 12 months, which is ongoing. The patient with metastatic LMS of the inferior vena cava received combination therapy at presentation and had persistent response for 12 months, at which time new metastases were found. The patient with soft tissue LMS had disease progression on pembrolizumab monotherapy prior to the addition of ascorbate, after which she had a 17-month response, which is ongoing. No side effects attributed to treatment were reported. Conclusion: Pembrolizumab plus pharmacologic ascorbate is a novel immunotherapeutic approach and warrants further study in LMS.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>39474533</pmid><doi>10.1159/000539979</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen ascorbate Biopsy Cancer Case Report Cell death Estrogens Hysterectomy immune checkpoint inhibitors Immunohistochemistry Immunotherapy leiomyosarcoma Ligands Medical history Medical imaging Medical prognosis Metastasis Oophorectomy pembrolizumab programmed death 1 Radiation Sarcoma soft tissue sarcoma Vitamin C |
| title | Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma |
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