{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:16:58Z","timestamp":1787026618376,"version":"build-2736575974"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dedifferentiated liposarcoma (DDLPS) is one of the most common types of soft tissue sarcoma (STS) characterized by liposarcomatous differentiation and a predilection for the retroperitoneum. Despite the growing number of histology-specific immune checkpoint blockade (ICB) trials in STS, it is still difficult to identify the radiographic objective response rate (ORR) for DDLPS in the real world setting. This study aimed to evaluate the ORR and survival of patients with DDLPS treated with ICB at a single center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of 31 patients with pathologically confirmed DDLPS treated with ICB at MD Anderson Cancer Center between 2018 and 2023. Patient demographics, disease characteristics, treatment history, and response to ICB were analyzed. Immunohistochemical analysis was performed on tumor samples to assess immune-related markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ORR by RECIST 1.1 was 3.2% (n=1\/31). Among all patients (n=31), 6% achieved partial radiographic response, while 39% had stable disease, and 55% showed progressive disease. Median progression-free survival (PFS) was 3.5 (95%CI:1.9, 4.7) months, and overall survival (OS) after ICB initiation was 19.7 (95%CI: 8.8, not reached) months. Patients without prior systemic therapy demonstrated better OS (p=0.004). Immunohistochemistry revealed no relationship between pre- or post-ICB expression of CD8, CD20, CD21 and PDL-1 and response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While the response to ICB in DDLPS remains limited, specific immune markers may influence treatment outcomes. CD20\/21 post-ICB appear more important for prognosis. Further research is warranted to identify predictive factors for ICB efficacy in DDLPS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1567736","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T01:37:04Z","timestamp":1745977024000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Dedifferentiated liposarcomas treated with immune checkpoint blockade: the MD Anderson experience"],"prefix":"10.3389","volume":"16","author":[{"given":"Madeline B.","family":"Torres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheuk Hong","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Zoghbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Lazcano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis","family":"Ingram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalida","family":"Wani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Z.","family":"Keung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Alejandra","family":"Zarzour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Scally","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly K.","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Conley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Bishop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Ashleigh","family":"Guadagnolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsan","family":"Farooqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devarati","family":"Mitra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison K.","family":"Yoder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Nakazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejka","family":"Araujo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Livingston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravin","family":"Ratan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyaskumar","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Ravi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Lazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Roland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeta","family":"Somaiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise F.","family":"Nassif Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz124","article-title":"Surgery in reference centers improves survival of sarcoma patients: a nationwide study","volume":"30","author":"Blay","year":"2019","journal-title":"Ann Oncol"},{"key":"B2","volume-title":"WHO Classification of Tumours of Soft Tissue and Bone","year":"2020"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2022.02.005","article-title":"New developments in the pathology and molecular biology of retroperitoneal sarcomas","volume":"49","author":"Watson","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0b013e32834796e6","article-title":"Clinical and molecular approaches to well differentiated and dedifferentiated liposarcoma","volume":"23","author":"Crago","year":"2011","journal-title":"Curr Opin Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.07.006","article-title":"Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up(\u2606)","volume":"32","author":"Gronchi","year":"2021","journal-title":"Ann Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2016.05.007","article-title":"Liposarcoma: multimodality management and future targeted therapies","volume":"25","author":"Crago","year":"2016","journal-title":"Surg Oncol Clin N Am"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30446-0","article-title":"Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial","volume":"21","author":"Bonvalot","year":"2020","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.04.005","article-title":"Radiation therapy for treatment of soft tissue sarcoma in adults: executive summary of an ASTRO clinical practice guideline","volume":"11","author":"Salerno","year":"2021","journal-title":"Pract Radiat Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21605","article-title":"Soft-tissue sarcoma in adults: An update on the current state of histiotype-specific management in an era of personalized medicine","volume":"70","author":"Gamboa","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B10","doi-asserted-by":"publisher","first-page":"10500","DOI":"10.1200\/jco.2015.33.15_suppl.10500","article-title":"GeDDiS: A prospective randomised controlled phase III trial of gemcitabine and docetaxel compared with doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft tissue sarcomas (EudraCT 2009-014907-29)","volume":"33","author":"Seddon","year":"2015","journal-title":"J Clin Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12916-017-0872-y","article-title":"Systemic treatment in advanced soft tissue sarcoma: what is standard, what is new","volume":"15","author":"Frezza","year":"2017","journal-title":"BMC Med"},{"key":"B12","unstructured":"Surgery with or without neoadjuvant chemotherapy in high risk retroperitoneal sarcoma (STRASS2): ClinicalTrials.gov identifier: NCT04031677\n          \n          \n          2023"},{"key":"B13","doi-asserted-by":"publisher","first-page":"11836","DOI":"10.1038\/s41598-017-12132-w","article-title":"Role of chemotherapy in dedifferentiated liposarcoma of the retroperitoneum: defining the benefit and challenges of the standard","volume":"7","author":"Livingston","year":"2017","journal-title":"Sci Rep"},{"key":"B14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.intimp.2018.06.001","article-title":"Immune checkpoint blockade therapy for cancer: An overview of FDA-approved immune checkpoint inhibitors","volume":"62","author":"Hargadon","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30020165","article-title":"The landscape of immunotherapy for retroperitoneal sarcoma","volume":"30","author":"Gingrich","year":"2023","journal-title":"Curr Oncol (Toronto Ont)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/s40364-023-00513-5","article-title":"Biomarkers for immune checkpoint inhibition in sarcomas - are we close to clinical implementation","volume":"11","author":"Yiong","year":"2023","journal-title":"Biomarker Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.775761","article-title":"Improving immunotherapy efficacy in soft-tissue sarcomas: A biomarker driven and histotype tailored review","volume":"12","author":"Roulleaux Dugage","year":"2021","journal-title":"Front Immunol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30006-8","article-title":"Nivolumab with or without ipilimumab treatment for metastatic sarcoma (Alliance A091401): two open-label, non-comparative, randomised, phase 2 trials","volume":"19","author":"D\u2019Angelo","year":"2018","journal-title":"Lancet Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.7027","article-title":"The role of immunotherapy in the management of soft tissue sarcomas: current landscape and future outlook","volume":"20","author":"Banks","year":"2022","journal-title":"J Natl Compr Cancer Netw"},{"key":"B20","doi-asserted-by":"publisher","first-page":"11015","DOI":"10.1200\/JCO.2019.37.15_suppl.11015","article-title":"Clinical activity of pembrolizumab (P) in undifferentiated pleomorphic sarcoma (UPS) and dedifferentiated\/pleomorphic liposarcoma (LPS): Final results of SARC028 expansion cohorts","volume":"37","author":"Burgess","year":"2019","journal-title":"J Clin Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13045-020-00891-5","article-title":"PD1\/PD-L1 targeting in advanced soft-tissue sarcomas: a pooled analysis of phase II trials","volume":"13","author":"Italiano","year":"2020","journal-title":"J Hematol Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30624-1","article-title":"Pembrolizumab in advanced soft-tissue sarcoma and bone sarcoma (SARC028): a multicentre, two-cohort, single-arm, open-label, phase 2 trial","volume":"18","author":"Tawbi","year":"2017","journal-title":"Lancet Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/s43018-024-00726-z","article-title":"A randomized, non-comparative phase 2 study of neoadjuvant immune-checkpoint blockade in retroperitoneal dedifferentiated liposarcoma and extremity\/truncal undifferentiated pleomorphic sarcoma","volume":"5","author":"Roland","year":"2024","journal-title":"Nat Cancer"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30074-8","article-title":"iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics","volume":"18","author":"Seymour","year":"2017","journal-title":"Lancet Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452","article-title":"Nonparametric estimation from incomplete observations","volume":"53","author":"Kaplan","year":"1958","journal-title":"J Am Stat Assoc"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.07.3411","article-title":"We should desist using RECIST, at least in GIST","volume":"25","author":"Benjamin","year":"2007","journal-title":"J Clin Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2512081403","article-title":"High-grade soft-tissue sarcomas: tumor response assessment\u2013pilot study to assess the correlation between radiologic and pathologic response by using RECIST and Choi criteria - PubMed","volume":"251","author":"Stacchiotti","year":"2009","journal-title":"Radiology"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.11.008","article-title":"Comparison of response evaluation criteria in solid tumours and Choi criteria for response evaluation in patients with advanced soft tissue sarcoma treated with trabectedin: a retrospective analysis","volume":"51","author":"Taieb","year":"2015","journal-title":"Eur J Cancer (Oxford England: 1990)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2020.38.15_suppl.11511","article-title":"A multicenter phase II study of nivolumab +\/- ipilimumab for patients with metastatic sarcoma (Alliance A091401): Results of expansion cohorts","volume":"38","author":"Chen","year":"2020","journal-title":"J Clin Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-23-1902","article-title":"Histologic and immunologic factors associated with response to immune checkpoint inhibitors in advanced sarcoma","volume":"31","author":"Lee","year":"2025","journal-title":"Clin Cancer research1"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr485","article-title":"Advanced well-differentiated\/dedifferentiated liposarcomas: role of chemotherapy and survival","volume":"23","author":"Italiano","year":"2012","journal-title":"Ann Oncol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.v128.15","article-title":"First-line chemotherapy in advanced intra-abdominal well-differentiated\/dedifferentiated liposarcoma: An EORTC Soft Tissue and Bone Sarcoma Group retrospective analysis","volume":"128","author":"Stacchiotti","year":"2022","journal-title":"Cancer"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.v127.6","article-title":"A randomized, open-label, phase 2, multicenter trial of gemcitabine with pazopanib or gemcitabine with docetaxel in patients with advanced soft-tissue sarcoma","volume":"127","author":"Somaiah","year":"2021","journal-title":"Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.6107","article-title":"Randomized phase II study comparing gemcitabine plus dacarbazine versus dacarbazine alone in patients with previously treated soft tissue sarcoma: a Spanish Group for Research on Sarcomas study","volume":"29","author":"Garc\u00eda-Del-Muro","year":"2011","journal-title":"J Clin Oncol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx536","article-title":"Gemcitabine plus sirolimus for relapsed and progressing osteosarcoma patients after standard chemotherapy: a multicenter, single-arm phase II trial of Spanish Group for Research on Sarcoma (GEIS)","volume":"28","author":"Martin-Broto","year":"2017","journal-title":"Ann Oncol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.v12.4","article-title":"Retrospective evaluation of the role of gemcitabine-docetaxel in well-differentiated and dedifferentiated liposarcoma","volume":"12","author":"Thirasastr","year":"2023","journal-title":"Cancer Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.01.180","article-title":"Phase II study of ET-743 in advanced soft tissue sarcomas: a European Organisation for the Research and Treatment of Cancer (EORTC) soft tissue and bone sarcoma group trial","volume":"23","author":"Le Cesne","year":"2005","journal-title":"J Clin Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.62.4734","article-title":"Efficacy and safety of trabectedin or dacarbazine for metastatic liposarcoma or leiomyosarcoma after failure of conventional chemotherapy: results of a phase III randomized multicenter clinical trial","volume":"34","author":"Demetri","year":"2016","journal-title":"J Clin Oncol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01283-0","article-title":"Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial","volume":"387","author":"Sch\u00f6ffski","year":"2016","journal-title":"Lancet (London England)"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1126\/science.aax0182","article-title":"Neoadjuvant checkpoint blockade for cancer immunotherapy","volume":"367","author":"Topalian","year":"2020","journal-title":"Sci (New York NY)"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1186\/s12935-020-01672-3","article-title":"Assessing immune infiltration and the tumor microenvironment for the diagnosis and prognosis of sarcoma","volume":"20","author":"Zhu","year":"2020","journal-title":"Cancer Cell Int"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1378398","article-title":"Clinical and translational implications of immunotherapy in sarcomas","volume":"15","author":"Recine","year":"2024","journal-title":"Front Immunol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15082287","article-title":"Current landscape of immunotherapy for advanced sarcoma","volume":"15","author":"Albarr\u00e1n","year":"2023","journal-title":"Cancers"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-019-0312-y","article-title":"Expression of lymphocyte immunoregulatory biomarkers in bone and soft-tissue sarcomas","volume":"32","author":"Dancsok","year":"2019","journal-title":"Modern Pathol"},{"key":"B46","doi-asserted-by":"crossref","DOI":"10.1200\/EDBK_432234","article-title":"Immunotherapy in sarcoma: current data and promising strategies","volume-title":"American Society of Clinical Oncology Educational Book","author":"Wood","year":"2024"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22147518","article-title":"Molecular determinants of soft tissue sarcoma immunity: targets for immune intervention","volume":"22","author":"Tazzari","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01812-9","article-title":"Safety and efficacy of pembrolizumab, radiation therapy, and surgery versus radiation therapy and surgery for stage III soft tissue sarcoma of the extremity (SU2C-SARC032): an open-label, randomised clinical trial","volume":"404","author":"Mowery","year":"2024","journal-title":"Lancet"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00392-8","article-title":"Durvalumab plus tremelimumab in advanced or metastatic soft tissue and bone sarcomas: a single-centre phase 2 trial","volume":"23","author":"Somaiah","year":"2022","journal-title":"Lancet Oncol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"7791","DOI":"10.1038\/s41586-019-1906-8","article-title":"B cells are associated with survival and immunotherapy response in sarcoma","volume":"577","author":"Petitprez","year":"2020","journal-title":"Nature"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1567736\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T01:37:07Z","timestamp":1745977027000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1567736\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":50,"alternative-id":["10.3389\/fimmu.2025.1567736"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1567736","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"article-number":"1567736"}}