Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma

John M. Rieth; Alex C. Belzer; Mackenzie L. Walhof; Mohammed M. Milhem

doi:10.1159/000539979

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Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma

Journal article

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Peer reviewed

Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma

John M. Rieth, Alex C. Belzer, Mackenzie L. Walhof and Mohammed M. Milhem

Case reports in oncology, Vol.17(1), pp.906-912

08/01/2024

DOI: 10.1159/000539979

PMCID: PMC11521403

PMID: 39474533

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Abstract

Introduction: Leiomyosarcoma (LMS) is a malignancy with smooth muscle differentiation. Metastatic LMS is associated with poor prognosis and limited efficacy of systemic treatment. Novel treatment modalities are desperately needed for this entity. Case Presentation: We report the first use of pembrolizumab plus pharmacologic ascorbate in 3 patients with metastatic LMS. All cases resulted in persistent objective responses and disease control significantly better than has been reported with chemotherapy or other immunotherapeutic approaches. Three patients with metastatic LMS, one each of uterine, vascular, and soft tissue origin, were treated with pembrolizumab plus pharmacologic ascorbate. The patient with uterine LMS received combination therapy at presentation and had persistent response for 12 months, which is ongoing. The patient with metastatic LMS of the inferior vena cava received combination therapy at presentation and had persistent response for 12 months, at which time new metastases were found. The patient with soft tissue LMS had disease progression on pembrolizumab monotherapy prior to the addition of ascorbate, after which she had a 17-month response, which is ongoing. No side effects attributed to treatment were reported. Conclusion: Pembrolizumab plus pharmacologic ascorbate is a novel immunotherapeutic approach and warrants further study in LMS.

Immunotherapy

ascorbate

immune checkpoint inhibitors

leiomyosarcoma

pembrolizumab

programmed death 1

soft tissue sarcoma

vitamin c

Details

Title: Subtitle: Pembrolizumab plus Pharmacologic Ascorbate in the Treatment of Leiomyosarcoma
Creators: John M. Rieth - University of Iowa
Alex C. Belzer - Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Mackenzie L. Walhof - University of Iowa
Mohammed M. Milhem - University of Iowa
Resource Type: Journal article
Publication Details: Case reports in oncology, Vol.17(1), pp.906-912
DOI: 10.1159/000539979
PMID: 39474533
PMCID: PMC11521403
NLM abbreviation: Case Rep Oncol
ISSN: 1662-6575
eISSN: 1662-6575
Publisher: Karger Publishers
Grant note: This study is supported by the University of Iowa Holden Comprehensive Cancer Center.
Language: English
Date published: 08/01/2024
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984698937702771

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