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Golding R, Abuqubo R, Pansa CJ, Bhatta M, Shankar V, Mani K, Kleinbart E, Gelfand Y, Murthy S, De la Garza Ramos R, Krystal J, Eleswarapu A, Yassari R, Mostafa E, Fourman MS, Schlumprecht A. Immunologic and Targeted Molecular Therapies for Chordomas: A Narrative Review. J Clin Med 2024; 13:5679. [PMID: 39407739 PMCID: PMC11476405 DOI: 10.3390/jcm13195679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 09/17/2024] [Accepted: 09/20/2024] [Indexed: 10/20/2024] Open
Abstract
Chordomas are rare sarcomas arising from notochordal tissue and occur most commonly in the spine. The standard of care for chordomas without evidence of metastatic disease generally consists of en bloc resection followed by adjuvant radiotherapy. However, long-term (20-year) survival rates are approximately 30%. Chordomas are generally considered as chemo resistant. Therefore, systemic therapies have rarely been employed. Novel immunotherapies, including antibody therapy and tumor vaccines, have shown promise in early trials, leading to extended progression-free survival and symptom relief. However, the outcomes of larger trials using these vectors are heterogeneous. The aim of this review is to summarize novel chordoma treatments in immune-targeted therapies. The current merits, trial outcomes, and toxicities of these novel immune and targeted therapies, including those targeting vascular endothelial growth factor receptor (VEGFR) targets and the epidermal growth factor receptor (EGFR), will be discussed.
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Affiliation(s)
- Regina Golding
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
| | - Rami Abuqubo
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Christopher J. Pansa
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Manish Bhatta
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Vishal Shankar
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Kyle Mani
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Emily Kleinbart
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (R.A.); (C.J.P.); (M.B.); (V.S.); (K.M.); (E.K.)
| | - Yaroslav Gelfand
- Department of Neurological Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (Y.G.); (S.M.); (R.D.l.G.R.); (R.Y.)
| | - Saikiran Murthy
- Department of Neurological Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (Y.G.); (S.M.); (R.D.l.G.R.); (R.Y.)
| | - Rafael De la Garza Ramos
- Department of Neurological Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (Y.G.); (S.M.); (R.D.l.G.R.); (R.Y.)
| | - Jonathan Krystal
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
| | - Ananth Eleswarapu
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
| | - Reza Yassari
- Department of Neurological Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (Y.G.); (S.M.); (R.D.l.G.R.); (R.Y.)
| | - Evan Mostafa
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
| | - Mitchell S. Fourman
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
| | - Anne Schlumprecht
- Department of Orthopaedic Surgery, Montefiore Einstein, Bronx, NY 10461, USA; (R.G.); (J.K.); (A.E.); (E.M.); (A.S.)
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Goumenos S, Kakouratos G, Trikoupis I, Gavriil P, Gerasimidis P, Soultanis K, Patapis P, Kontogeorgakos V, Papagelopoulos P. Clinical Outcome after Surgical Treatment of Sacral Chordomas: A Single-Center Retrospective Cohort of 27 Patients. Cancers (Basel) 2024; 16:973. [PMID: 38473334 DOI: 10.3390/cancers16050973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction: The aims of our study were (1) to determine disease-specific and disease-free survival after the en-bloc resection of sacral chordomas and (2) to investigate potential risk factors for tumor recurrence and major postoperative wound-related complications. Methods: We retrospectively analyzed 27 consecutive patients with sacral chordomas who were surgically treated in our institution between 2004 and 2022. Three patients (11.1%) had a recurrent tumor and four patients (14.8%) had history of a second primary solid tumor prior to or after their sacral chordoma. A combined anterior and posterior approach, colostomy, plastic reconstruction, and spinopelvic instrumentation were necessitated in 51.9%, 29.6%, 37%, and 7.4% of cases, respectively. The mean duration of follow-up was 58 ± 41 months (range= 12-170). Death-related-to-disease, disease recurrence, and major surgical site complications were analyzed using Kaplan-Meier survival analysis, and investigation of the respective risk factors was performed with Cox hazard regression. Results: The estimated 5-year and 10-year disease-specific survival was 75.3% (95% CI = 49.1-87.5%) and 52.7% (95% CI = 31-73.8%), respectively. The estimated 1-year, 5-year, and 10-year disease-free survival regarding local and distant disease recurrence was 80.4% (95% CI = 60.9-91.1%), 53.9% (95% CI = 24.6-66.3%), and 38.5% (95% CI = 16.3-56.2%), respectively. The mean survival of the recurred patients was 61.7 ± 33.4 months after their tumor resection surgery. Conclusions: Despite the high relapse rates and perioperative morbidity, long-term patient survival is not severely impaired. Positive or less than 2 mm negative resection margins have a significant association with disease progression.
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Affiliation(s)
- Stavros Goumenos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Georgios Kakouratos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Ioannis Trikoupis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Panagiotis Gavriil
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Pavlos Gerasimidis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Konstantinos Soultanis
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Pavlos Patapis
- 3rd Department of Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Vasileios Kontogeorgakos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
| | - Panayiotis Papagelopoulos
- 1st Department of Orthopaedic Surgery, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12461 Athens, Greece
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