# Efficacy of toripalimab in combination with anlotinib in recurrent undifferentiated pleomorphic sarcoma of the sinonasal region: a case report with biomarker analysis

## TL;DR

A 63-year-old woman with rare sinonasal undifferentiated pleomorphic sarcoma showed a strong response to toripalimab and anlotinib after previous treatments failed.

## Contribution

This case report demonstrates the potential efficacy of toripalimab and anlotinib in treating rare sinonasal undifferentiated pleomorphic sarcoma.

## Key findings

- The patient showed a significant partial response after two cycles of toripalimab and anlotinib.
- Continued partial response was observed after six additional cycles, suggesting prolonged effectiveness.
- Biomarker analysis showed rapidly dividing sarcoma cells enriched in vasculature prior to treatment.

## Abstract

Soft tissue sarcoma (STS) typically originates in the muscles and is associated with a poor prognosis. Undifferentiated pleomorphic sarcoma (UPS) is the most commonly diagnosed subtype of STS; however, UPS occurring in the sinonasal region is exceedingly rare and lacks effective treatment options.

This case report presents a patient with sinonasal UPS who experienced disease progression after surgery and chemotherapy but showed a positive response to combination therapy with toripalimab and anlotinib. Additionally, it explores the underlying biomarkers associated with this case.

A 63-year-old woman with no significant past medical history was diagnosed with sinonasal UPS. The lesions recurred despite seven extensive surgical resections, and standard chemotherapy failed to control the disease, leading to progressive disease (PD).

The patient was treated with a combination of toripalimab and anlotinib, resulting in a significant partial response (PR) after just two cycles. Continued PR was observed after an additional six cycles, indicating the potential for a prolonged response with ongoing therapy. Genotyping and immunohistochemistry revealed that the sarcoma cells were rapidly dividing and enriched in vasculature prior to systemic treatment.

These findings suggest that the combination of toripalimab and anlotinib may be an effective treatment option for advanced cases of UPS in the sinonasal region.