1/1/2023 0 Comments Cm 2008 Editor![]() ![]() Cytogenetic and comparative genomic hybridization studies have revealed few abnormalities in early KS, such as clonal loss of chromosome Y, whereas additional chromosomal aberrations can be detected in more advanced stages of the disease. ![]() 5 It is now known that all KS are associated with HHV-8 infection. It is worth emphasizing that in Merkel cell polyomavirus (MCPyV)–associated Merkel cell carcinoma (MCC), which represents up to 80% of cases in the United States and Europe, TMB has been shown to be low (12.5 mutations per exome), whereas the benefit from ICI is at least as good as in MCPyV-negative, UV-induced MCC, which carries a high TMB (1,121 mutations per exome). ![]() However, other markers have recently been unveiled, such as PD-L1 amplification 4 and, most importantly, immunogenicity of virus-associated antigens in virus-associated tumors. We agree that a high tumor mutational burden (TMB) is generally associated with an increased tumor response to ICI. However, KS subsequently relapsed within 5 months with major bone involvement, leading to the reinstitution of chemotherapy. The myocarditis was successfully treated with high doses of intravenous methylprednisolone and immunoglobulin therapy, followed by 6 weeks of systemic corticosteroids. Indeed, one of our patients developed severe immune-related myocarditis, resulting in acute pulmonary edema and cardiogenic shock, with a left ventricular ejection fraction reduction to 25%, requiring several days of noninvasive ventilation and inotropic support. 3 Therefore, the benefits of immune checkpoint inhibition (ICI) may be overshadowed. Although these treatments are essential for the management of irAEs, they are also associated with KS promotion, including classic KS. 2Īlthough both of our patients similarly experienced durable partial responses to PD-1 inhibition, it is of paramount importance to keep in mind that up to 15% of patients may experience severe immune-related adverse events (irAEs), most often requiring the administration of high doses of steroids and/or immunosuppressive treatments. We read with great interest the article by Saller et al, 1 which extends the observations of our previous report of 2 cases of classic Kaposi sarcoma (KS) successfully treated with PD-1 blockade. ![]() Response to Checkpoint Inhibitor Therapy in Advanced Classic Kaposi Sarcoma: A Case Report and Immunogenomic Study. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |