Neoadjuvant Blockade Demonstrates Significant Clinical Activity in UPS

Christina L. Roland, MD, PhD, chief of Sarcoma Surgery and assistant professor in the Department of Surgical Oncology, Division of Surgery, and associate medical director of the Sarcoma Center at The University of Texas MD Anderson Cancer Center, discusses the preliminary results of neoadjuvant checkpoint blockade—nivolumab (Opdivo) or nivolumab plus ipilimumab (Yervoy)—in patients with surgically resectable undifferentiated pleomorphic sarcoma (UPS) and dedifferentiated liposarcoma (DDLPS).

This phase 2 study (NCT03307616) had 23 patients that have been reported on and data from 4 more that have been treated but did not have enough data at the time of the data cut-off for the presentation at the 2020 American Society of Clinical Oncology Virtual Scientific Program, according to Roland. Of the 23 patients, 14 had DDLPS and 9 had UPS. She says the most exciting findings are in the UPS cohort.

For the UPS arm, there was not much difference between nivolumab compared with nivolumab plus ipilimumab, except for more toxicity with the doublet. As for the efficacy, 8 of the 9 patients had less than 15% residual tumor remaining. When looking at the historical data before designing the study, the median amount of hyalinization for radiation alone or chemotherapy and radiation was about 5% to 10%. For this study, it was about 90% for the UPS cohort. Although there was not a group in this study receiving radiation alone, the historically data worked as a reference.

There was not as much historical data for the DDLPS cohort, but the median amount hyalinization in this group was around 20% to 25%. Though it’s not as much as the UPS group, this therapy could still be considered as an alternative to chemotherapy and other regimens for this patient population, Roland says.

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