Dedifferentiated Liposarcomas Treated With Immune Checkpoint Blockade: The MD Anderson Experience

Authors

Madeline B Torres
Cheuk Hong Leung
Marianne Zoghbi
Rossana Lazcano
Davis Ingram
Khalida Wani
Emily Z Keung
M Alejandra Zarzour
Christopher P Scally
Kelly K Hunt
Anthony Conley
Andrew J Bishop
B Ashleigh Guadagnolo
Ahsan Farooqi
Devarati Mitra
Alison K Yoder
Michael S Nakazawa
Dejka Araujo
Andrew Livingston
Ravin Ratan
Shreyaskumar Patel
Vinod Ravi
Alexander J Lazar
Christina L Roland
Neeta Somaiah
Elise F Nassif Haddad

Publication Date

1-1-2025

Journal

Frontiers in Immunology

Abstract

Background: Dedifferentiated liposarcoma (DDLPS) is one of the most common types of soft tissue sarcoma (STS) characterized by liposarcomatous differentiation and a predilection for the retroperitoneum. Despite the growing number of histology-specific immune checkpoint blockade (ICB) trials in STS, it is still difficult to identify the radiographic objective response rate (ORR) for DDLPS in the real world setting. This study aimed to evaluate the ORR and survival of patients with DDLPS treated with ICB at a single center.

Methods: We conducted a retrospective study of 31 patients with pathologically confirmed DDLPS treated with ICB at MD Anderson Cancer Center between 2018 and 2023. Patient demographics, disease characteristics, treatment history, and response to ICB were analyzed. Immunohistochemical analysis was performed on tumor samples to assess immune-related markers.

Results: ORR by RECIST 1.1 was 3.2% (n=1/31). Among all patients (n=31), 6% achieved partial radiographic response, while 39% had stable disease, and 55% showed progressive disease. Median progression-free survival (PFS) was 3.5 (95%CI:1.9, 4.7) months, and overall survival (OS) after ICB initiation was 19.7 (95%CI: 8.8, not reached) months. Patients without prior systemic therapy demonstrated better OS (p=0.004). Immunohistochemistry revealed no relationship between pre- or post-ICB expression of CD8, CD20, CD21 and PDL-1 and response.

Conclusion: While the response to ICB in DDLPS remains limited, specific immune markers may influence treatment outcomes. CD20/21 post-ICB appear more important for prognosis. Further research is warranted to identify predictive factors for ICB efficacy in DDLPS.

Keywords

Humans, Male, Female, Liposarcoma, Middle Aged, Immune Checkpoint Inhibitors, Aged, Retrospective Studies, Adult, Aged, 80 and over, Treatment Outcome, sarcoma, dedifferentiated liposarcoma, Anti-PD1, immunotherapy, immune-checkpoint inhibitors, survival

DOI

10.3389/fimmu.2025.1567736

PMID

40370451

PMCID

PMC12075363

PubMedCentral® Posted Date

4-30-2025

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes