Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment

Thomas A. Vander Jagt, Lara Davis, Meghna Das Thakur, Carl Franz, Jeffrey Pollock

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezolizumab), a monoclonal anti-programmed death ligand-1 antibody. Imaging results for the patient suggested disease progression of multiple brain metastases with stable systemic disease. The patient met response evaluation criteria in solid tumors (RECIST) criteria of progression of disease and was removed from treatment with MPDL3280. Subsequent surgical resection of the brain lesions revealed nonviable tumor with extensive lymphocytic infiltrates consistent with pseudoprogression. This case report adds to a growing number of reports that question reliance on RECIST criteria and suggest need for further refinement of RECIST or irRECIST during immune checkpoint inhibitor treatment for central nervous system metastatic lesions.

Original languageEnglish (US)
Pages (from-to)882-885
Number of pages4
JournalRadiology Case Reports
Volume13
Issue number4
DOIs
StatePublished - Aug 1 2018

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Alveolar Soft Part Sarcoma
Central Nervous System Diseases
Disease Progression
Brain
Renal Cell Carcinoma
Non-Small Cell Lung Carcinoma
Melanoma
Therapeutics
Central Nervous System
Clinical Trials
Pediatrics
Neoplasm Metastasis
Ligands
Antibodies
Response Evaluation Criteria in Solid Tumors
Neoplasms

Keywords

  • Alveolar soft part sarcoma
  • PDL1
  • Pseudoprogression

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment. / Vander Jagt, Thomas A.; Davis, Lara; Thakur, Meghna Das; Franz, Carl; Pollock, Jeffrey.

In: Radiology Case Reports, Vol. 13, No. 4, 01.08.2018, p. 882-885.

Research output: Contribution to journalArticle

Vander Jagt, Thomas A. ; Davis, Lara ; Thakur, Meghna Das ; Franz, Carl ; Pollock, Jeffrey. / Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment. In: Radiology Case Reports. 2018 ; Vol. 13, No. 4. pp. 882-885.
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