From the Research
Follicular dendritic cell sarcoma (FDCS) should be treated with a PD-1 inhibitor plus chemotherapy as first-line treatment for metastatic disease, as it has shown a favorable response and relatively long progression-free survival in recent studies. The treatment of FDCS typically involves complete surgical resection when possible, as this offers the best chance for cure [ 1 ]. For localized disease, surgery alone may be sufficient, but adjuvant radiation therapy is often recommended for cases with positive margins or high-risk features. In advanced or metastatic disease, a multimodal approach including chemotherapy is necessary, with common regimens including CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or ICE (ifosfamide, carboplatin, etoposide) [ 2 ]. However, the most recent study [ 1 ] suggests that a PD-1 inhibitor plus chemotherapy may be a more effective treatment option for metastatic FDCS, with a partial response and a relatively long progression-free survival of 17 months. Due to the rarity of FDCS, there are no standardized treatment protocols, and therapy is often individualized [ 3 ]. Prognosis varies, with a 5-year overall survival rate of approximately 70% for localized disease but significantly lower for metastatic cases [ 4 ]. Regular follow-up with imaging studies every 3-6 months for the first two years is essential for monitoring recurrence [ 5 ]. Some key points to consider in the treatment of FDCS include:
- The importance of complete surgical resection when possible
- The use of adjuvant radiation therapy for cases with positive margins or high-risk features
- The need for a multimodal approach including chemotherapy for advanced or metastatic disease
- The potential benefit of a PD-1 inhibitor plus chemotherapy as first-line treatment for metastatic disease
- The importance of regular follow-up with imaging studies to monitor recurrence.