Sarcomas are uncommon tumors. Currently, no effective systemic therapeutic modality for patients with advanced sarcomas exists, and the prognosis remains very poor. The advent of PD-1-blocking agents changed the treatment modality for many types of solid tumors, in which they show satisfactory efficacy. However, data corresponding to sarcomas, especially from randomized clinical studies of PD-1 blockade, are rare, and no results of randomized Phase 3 studies of PD-1 blockade in sarcomas are available. Sarcomas represent a large group of heterogeneous diseases including more than 50 subtypes, and the tumor microenvironment is highly complicated. PD-1 blockade monotherapy cannot achieve satisfactory efficacy according to the available data. As research on the sarcomas microenvironment proceeds, it may be possible to identify patients who are sensitive to PD-1 blockade by examination of PD-L1 expression, TMB, and MSI. For unselected sarcoma patients, PD-1 blockade combined with other types of treatment, such as localized radiation, tumor injection with cytokines or oncolytic viruses, and treatment with other types of immunomodulatory agents, may provide better results.


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PD-1, programmed death protein 1; Ig, immunoglobulin; MoAb, onoclonal antibody; STS, soft tissue sarcoma; UPS, undifferentiated pleomorphic sarcoma; PFS, progression-free survival; SAE, severe adverse events; PD-L1, programmed death protein ligand 1; TAM, tumor-associated macrophage; SBRT, stereotactic body radiotherapy; VEGF, vascular endothelial growth factor; VEGFR, vascular endothelial growth factor receptor; MDSCs, myeloid-derived suppressor cells; Tregs, regulatory T cells; CTL, cytotoxic T lymphocyte; PDGFR, platelet-derived growth factor receptor; TMB tumor mutation burden; TIL, tumor-infiltrating lymphocyte; MSI, microsatellite instability; MMR, mismatch repair.


We would like to give our thanks to for the language editing. This study was funded by Industry-University-Research Collaboration of Health Commission of Henan Province (No. 182107000027).


The authors report no conflicts of interest in this work.

Wenli Zuo, Lingdi Zhao

Hematology Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou City 450008, People’s Republic of China

Correspondence: Lingdi Zhao
Hematology Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, No. 127 Dongming Road, Jinshui District, Zhengzhou City 450008, People’s Republic of China
E-mail: [email protected]


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Source: OncoTargets and Therapy.
Originally published August 23, 2019.

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