The results, published in ‘The Lancet’, establish pembrolizumab as a new option for these patients.
“Soft tissue sarcoma is a rare and complex disease with more than 50 subtypes, making it difficult to study in large clinical trials,” explains Yvonne Mowery, author of the study. “Given that we have made little progress in its treatment in decades, it is exciting to see that this trial shows that pembrolizumab can improve outcomes beyond standard treatment in patients with locally advanced disease.”
In this sense, David Kirsch points out that «This trial represents an important advance for patients with the types of sarcoma included in the study. “We found that immunotherapy can improve outcomes in patients with the most aggressive forms of the disease, suggesting that optimizing it further could provide greater benefits.”
Soft tissue sarcoma of the extremities affects muscles, tendons, fat, blood vessels or nerves in the arms and legs. About half of patients with large, high-grade sarcomas develop incurable metastases, so it is key to intervene before the onset of metastatic disease, explains Mowery.
Typically, patients receive surgery combined with radiation therapy; Some also receive chemotherapy, although its effectiveness is limited and it carries high toxicity.
This trial included patients in the US, Canada, Australia, and Italy with stage 3 and grade 2 or 3 sarcoma, including two subtypes: undifferentiated pleomorphic sarcoma and dedifferentiated liposarcoma.
The control group received preoperative radiotherapy and surgery, while the experimental group also received pembrolizumab infusions before and after surgery. With a total of 127 patients, the two-year disease-free survival rate was 52% in the control group and 67% in the experimental group, indicating that the addition of pembrolizumab reduced recurrence or death.
Although it is still premature to confirm whether pembrolizumab improves overall survival, researchers will continue to monitor patients to answer this question.
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