Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://www.jocmr.org

Case Report

Volume 15, Number 10-11, December 2023, pages 461-468

Treatment With Antitumor Agents Recommended by Cancer Genome Panel for Uterine Leiomyosarcoma

Figures

Figure 1.
Figure 1. Histopathological findings of case 1. The patient in case 1 was diagnosed with uterine leiomyosarcoma by histopathological examination. Histopathological examination revealed no malignant tumor cells in the ovaries and fallopian tubes.
Figure 2.
Figure 2. Contrast-enhanced CT showing intraperitoneal disseminated lesions in case 1 patient. Images of intra-abdominal disseminated lesions in case 1 patients taken by contrast-enhanced CT on June 27, 2023, and September 20, 2023, are presented. The lesions of the intraperitoneal disseminated lesions are worsening. Yellow circles indicate intraperitoneal disseminated lesions. CT: computed tomography.
Figure 3.
Figure 3. Chest CT showing metastatic lesions to the lungs of case 1 patient. Images of metastatic lesions to the lungs of case 1 patients taken by chest CT on June 27, 2023, and September 20, 2023 are presented. The lesions of metastatic lesions to the lungs are shrinking. Yellow circles indicate metastatic lesions to the lungs. CT: computed tomography.
Figure 4.
Figure 4. Progressive pelvic tumor of recurrent uterine leiomyosarcoma in case 2 patient by contrast-enhanced CT (October 6, 2022). Images of progressive pelvic tumor of recurrent uterine leiomyosarcoma in case 2 patient taken by contrast-enhanced CT are presented. The advanced pelvic tumor is getting worse. The yellow dashed line surrounds the advanced pelvic tumor.

Tables

Table 1. FoundationOne® CDx Tissue Testing Results for the 55-Year-Old Patient With Advanced and Recurrent Uterine Leiomyosarcoma
 
Biomarker findingsTherapies with clinical relevance (in patient’s tumor type)Therapies with clinical relevance (in other tumor types)
VAF: variant allele fraction.
Tumor mutational burden (14 Muts/Mb)PembrolizumabAtezolizumab
DostarlimabAvelumab
Cemiplimab
Durvalumab
Nivolumab
Nivolumab + ipilimumab
Microsatellite status - MS-equivocalNo therapies or clinical trials. See biomarker findings section
Genomic findingsTherapies with clinical relevance (in patient’s tumor type)Therapies with clinical relevance (in other tumor types)
ARAF - E89K VAF 32.47%NoneNone
Variants to consider for follow-up germline testing in selected cancer susceptibility genes
MSH6 - F1088fs*5 VAF 1.51%MUTYH - splice site 892-2A>G VAF 50.32%

 

Table 2. FoundationOne® CDx Tissue Testing Results for the 82-Year-Old Patient With Advanced and Recurrent Uterine Leiomyosarcoma
 
Biomarker findingsTherapy and clinical trial implications
VAF: variant allele fraction.
Microsatellite status - MS-stableNo therapies or clinical trials. See biomarker findings section
Tumor mutational burden (2 Muts/Mb)No therapies or clinical trials. See biomarker findings section
Genomic findingsTherapies with clinical relevance (in patient’s tumor type)Therapies with clinical relevance (in other tumor types)
AKT1 - E17K VAF 11.56%NonePazopanib
Variants to consider for follow-up germline testing in selected cancer susceptibility genes
ATRX - L1250* VAF 39.98%RB1 - loss exons 18-27 CN0
MED12 - G44S VAF 44.88%TP53 - G187V, K132N VAF 44.89%