Anaplastic Classic Kaposi Sarcoma: PD-L1 Expression and Response to Immunotherapy: A Case Report and Review of the Literature

Authors:
Ivan Lolli Oncology Unit of National Institute of Gastroenterology “S. De Bellis,” Research Hospital Castellana Grotte, Bari, Italy

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Anna Maria Valentini Histopathology Unit of National Institute of Gastroenterology “S. De Bellis,” Research Hospital Castellana Grotte, Bari, Italy

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Angela Dalia Ricci Oncology Unit of National Institute of Gastroenterology “S. De Bellis,” Research Hospital Castellana Grotte, Bari, Italy

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Raffaele Armentano Histopathology Unit of National Institute of Gastroenterology “S. De Bellis,” Research Hospital Castellana Grotte, Bari, Italy

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Volume/Issue:
Volume 21: Issue 5
Online Publication Date:
07 Apr 2023
DOI:
https://doi.org/10.6004/jnccn.2022.7091
Restricted access

Anaplastic classic Kaposi sarcoma (CKS) is an extremely rare pathologic variant of CKS characterized by high aggressiveness and poor prognosis. We report the clinical course of this malignant histologic form in an otherwise healthy 67-year-old male from Apulia in Southern Italy. The anaplastic progression arose during a long history of CKS and developed after multiple local and systemic treatments. The extremely aggressive and chemorefractory nature of the disease dictated amputation of a lower limb and, later, surgery for metastatic pulmonary involvement. At subsequent relapse, therapy with the anti–PD-1 inhibitor pembrolizumab was started. The immunotherapy was selected based on the PD-L1 expression in the tumor and tumor microenvironment. Remarkably, PD-1 blockade induced a complete and durable response in the patient, with a disease-free survival that has exceeded 18 months, and follow-up is still ongoing.

Submitted March 14, 2022; final revision received October 20, 2022; accepted for publication October 20, 2022. Published online April 7, 2023.

Disclosures: The authors have disclosed that they have not received any financial considerations from any person or organization to support the preparation, analysis, results, or discussion of this article.

Correspondence: Ivan Lolli, MD, Oncology Unit of National Institute of Gastroenterology “S. De Bellis,” 70013 Via Turi 27, Castellana Grotte, Bari, Italy. Email: ivanlolli53@gmail.com

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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2023 by the National Comprehensive Cancer Network 2023
Article Category:
Research Article
Received:
14 Mar 2022
Accepted:
20 Oct 2022
Print Publication Date:
01 May 2023
Online Publication Date:
07 Apr 2023
Keywords:
anaplastic classic Kaposi Sarcoma; immunotherapy; Pembrolizumab; PD-L1 expression.

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