Would you offer immunotherapy for recurrent metastatic Ewing sarcoma if the tumor is MSI high or has high TMB?
Answer from: Medical Oncologist at Academic Institution
Yes, though this is an unlikely event given the transcription factor driven disease. NCCN lists pembro for TMB-H or MSI-H tumors, though I do not think any of the trials included Ewing Sarcoma. Probably better to use salvage regimens such as cyclo/topo or iri/temo first. Then work way to multikinase...
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Answer from: Medical Oncologist at Academic Institution
Limited data available (e.g.from SARC 028 - Tawbi et al., PMID 28988646) does not suggest any reasonable activity of CPI in Ewing sarcoma subset. Treating the patient on a "basket trial" of TMB-H or MSI-H would be reasonable, but not as standard of care.