Cutaneous angiosarcoma (CAS) is a rare malignant sarcoma for which there is no effective
treatment. The prognosis is extremely poor, and the development of novel therapies
is crucial. In general, soft tissue sarcomas are considered immunologically cold,
but immune checkpoint inhibitors (ICIs), including anti-programmed death-1 (PD-1)
antibodies, were recently reported to be effective against CAS [
[1]
,
[2]
]. In most malignant tumors, high expression of programmed death-ligand 1 (PD-L1)
is associated with a poor prognosis and PD-1/PD-L1 blockade is therefore expected
to produce successful results. The tumor immune response in CAS is still unclear,
however, and even the prognostic value of the expression of PD-L1 in CAS remains controversial
[
[3]
,
[4]
]. Some reports suggest that tertiary lymphoid structures (TLSs), defined as CD20-positive
B cell follicles surrounded by CD3-positive T cells, are promising biomarkers that
correlate with a better prognosis in several cancers, including malignant melanoma
and sarcomas, but their correlation with the prognosis in CAS is not yet established
[
[5]
,
- Cabrita R.
- Lauss M.
- Sanna A.
- Donia M.
- Larsen M.S.
- Mitra S.
- Johansson I.
- Phung B.
- Harbst K.
- Vallon-Christersson J.
- van Schoiack A.
- Lövgren K.
- Warren S.
- Jirström K.
- Olsson H.
- Pietras K.
- Ingvar C.
- Isaksson K.
- Schadendorf D.
- Schmidt H.
- Bastholt L.
- Carneiro A.
- Wargo J.A.
- Svane I.M.
- Jönsson G.
Tertiary lymphoid structures improve immunotherapy and survival in melanoma.
Nature. 2020; 577: 561-565
[6]
]. The presence of TLSs is thought to help promote anti-tumor immunity, and tumors
with TLS are more responsive to ICIs than those without TLSs [
[7]
]. The present study investigated tumor immunity-related factors, including PD-L1
and TLSs, to clarify useful prognostic biomarkers in CAS.To read this article in full you will need to make a payment
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References
- Angiosarcoma of the scalp responding to nivolumab: a case report.Br. J. Dermatol. 2018; 179: 530-531
- Angiosarcoma patients treated with immune checkpoint inhibitors: a case series of seven patients from a single institution.J. Immunother. Cancer. 2019; 7: 213
- Positive PD-L1 expression predicts worse outcome in cutaneous angiosarcoma.J. Glob. Oncol. 2016; 3: 360-369
- Infiltration of PD-1-positive cells in combination with tumor site PD-L1 expression is a positive prognostic factor in cutaneous angiosarcoma.Oncoimmunology. 2016; 6e1253657
- Tertiary lymphoid structures improve immunotherapy and survival in melanoma.Nature. 2020; 577: 561-565
- B cells are associated with survival and immunotherapy response in sarcoma.Nature. 2020; 577: 556-560
- B cells and tertiary lymphoid structures promote immunotherapy response.Nature. 2020; 577: 549-555
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Article info
Publication history
Published online: May 25, 2021
Received:
May 4,
2021
Identification
Copyright
© 2021 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.
