Complete Response to Dual Immunotherapy in a Young Adult with Metastasis ASPS

[Johannes]

This is a really encouraging case report (abstract below and full article attached).

Abstract

Alveolar soft part sarcoma (ASPS) is an extremely rare tumor that frequently occurs in adolescent and young
adults (AYA). Survival is poor for patients with metastatic and/or relapsed disease not amenable to local
control, and limited therapeutic options are available. A major barrier to cancer care in the United States AYA
population is lack of access to coordinated care and appropriate therapies for those who lack insurance or who
are underinsured. We report a 25-year-old unemployed, uninsured, single mother who presented with a 12.8 · 21cm
soft tissue thigh mass with heterogeneous avidity, max standardized uptake value of 9, with metastatic disease
to the ipsilateral inguinal lymph nodes and to the bilateral lungs. After local control of the primary mass was
obtained, a recently developed, comprehensive drug replacement program (DRP) was used to gain access to
nivolumab, and after frank progression was noted, ipilimumab was added every 6 weeks. No biomarkers associated
with response to immunotherapy were identified. After four cycles, a complete response was observed
and patient remains disease free 36 months after beginning dual immunotherapy treatment. We obtained
immunotherapy agents through a DRP and describe the development and the utility of this program in the
community setting. Our report highlights both first documented sustained complete response to sequenced
immunotherapy in an AYA with ASPS as well as a comprehensive DRP, which enabled access to therapy
for our patient.