Atezolizumab for Advanced Alveolar Soft Part Sarcoma

Alice P. Chen, Elad Sharon, Geraldine O’Sullivan‑Coyne, Nancy Moore, Jared C. Foster, James S. Hu, Brian A. Van Tine, Anthony P. Conley, William L. Read, Richard F. Riedel, Melissa A. Burgess, John Glod, Elizabeth J. Davis, Priscilla Merriam, Abdul R. Naqash, Kristin K. Fino, Brandon L. Miller, Deborah F. Wilsker, Asma Begum, Katherine V. Ferry‑GalowHari A. Deshpande, Gary K. Schwartz, Brian H. Ladle, Scott H. Okuno, Jill C. Beck, James L. Chen, Naoko Takebe, Laura K. Fogli, Christina L. Rosenberger, Ralph E. Parchment, James H. Doroshow

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Alveolar soft part sarcoma (ASPS) is a rare soft-tissue sarcoma with a poor prognosis and no established therapy. Recently, encouraging responses to immune checkpoint inhibitors have been reported. METHODS We conducted an investigator-initiated, multicenter, single-group, phase 2 study of the anti–programmed death ligand 1 (PD-L1) agent atezolizumab in adult and pediatric patients with advanced ASPS. Atezolizumab was administered intravenously at a dose of 1200 mg (in patients ≥18 years of age) or 15 mg per kilogram of body weight with a 1200-mg cap (in patients <18 years of age) once every 21 days. Study end points included objective response, duration of response, and progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1, as well as pharmacodynamic biomarkers of multistep drug action. RESULTS A total of 52 patients were evaluated. An objective response was observed in 19 of 52 patients (37%), with 1 complete response and 18 partial responses. The median time to response was 3.6 months (range, 2.1 to 19.1), the median duration of response was 24.7 months (range, 4.1 to 55.8), and the median progression-free survival was 20.8 months. Seven patients took a treatment break after 2 years of treatment, and their responses were maintained through the data-cutoff date. No treatment-related grade 4 or 5 adverse events were recorded. Responses were noted despite variable baseline expression of programmed death 1 and PD-L1. CONCLUSIONS Atezolizumab was effective at inducing sustained responses in approximately one third of patients with advanced ASPS.

Original languageEnglish
Pages (from-to)911-921
Number of pages11
JournalNew England Journal of Medicine
Volume389
Issue number10
DOIs
StatePublished - 2023

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