Dr. Roland on the Rationale for a Neoadjuvant Checkpoint Blockade in Sarcoma

Christina L. Roland, MD, PhD, chief of Sarcoma Surgery; an assistant professor in the Department of Surgical Oncology in the Division of Surgery; and associate medical director of the Sarcoma Center at The University of Texas MD Anderson Cancer Center, discusses the rationale for a phase 2 study (NCT03307616) evaluating neoadjuvant checkpoint blockade study in patients with undifferentiated pleomorphic sarcoma (UPS) and dedifferentiated liposarcoma (DDLPS).

In recent years, immunotherapy has started to emerge as a potential treatment modality in sarcoma, says Roland. At the 2019 ASCO Annual Meeting, results of the phase 2 SARC028 trial demonstrated objective responses with pembrolizumab (Keytruda) rates in both UPS and DDLPS.

In another phase 2 trial, nivolumab (Opdivo) was evaluated as a single-agent and in combination with ipilimumab (Yervoy) in the neoadjuvant setting. Notably, in this setting, patients typically have a lower burden of disease and are more likely to be cured.

The randomized phase 2 trial was modeled after a melanoma study, says Roland. The study was designed to assess the pathological response, a surrogate outcome for survival.

The results of the study showed significant clinical activity in patients with UPS who received nivolumab with or without ipilimumab plus concurrent radiation therapy, Roland concludes.