Case Report

Notable response to nivolumab during the treatment of SMARCA4-deficient thoracic sarcoma: a case report

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Rie Sakakibara

*Author for correspondence: Tel.: +81 358 035 954; Fax: +81 358 030 260;

E-mail Address: rsakakibara.pulm@tmd.ac.jp

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Masahiro Ishizuka

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Takayuki Honda

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Tsuyoshi Shirai

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Tsukasa Okamoto

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Tomoya Tateishi

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Hiroyuki Sakashita

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

Cancer Center, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Meiyo Tamaoka

The Department of Respiratory Medicine, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Akira Takemoto

The Department of Pathology, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Yuichi Kumaki

Cancer Center, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Sadakatsu Ikeda

Cancer Center, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Yasunari Miyazaki

Cancer Center, Tokyo Medical & Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

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Published Online:3 May 2020https://doi.org/10.2217/imt-2019-0142

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Abstract

SMARCA4-deficient thoracic sarcoma is a rare tumor typically presenting as a mediastinal mass. The prognosis is estimated to be poor, and no effective treatment has been established. We present a case of a 76-year-old man who was diagnosed with SMARCA4-deficient thoracic sarcoma. The provisional diagnosis was carcinoma of unknown primary but subsequently corrected to SMARCA4-deficient thoracic sarcoma based on the panel-based cancer gene screening and immunohistochemistry. Cytotoxic chemotherapy as the first- and second-line did not reveal enough therapeutic effects but third-line therapy using nivolumab showed marked tumor regression, which was sustained. This is the first case report of SMARCA4-deficient thoracic sarcoma showing a good response to nivolumab. Immune checkpoint inhibitor might be therapeutic candidates for this type of tumor.

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Papers of special note have been highlighted as: • of interest.

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Vol. 12, No. 8

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History

Received 11 August 2019

Accepted 20 April 2020

Published online 3 May 2020

Published in print June 2020

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Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.

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