Independent recommendation on further treatment options (Dr. M. Kebenko) — transcribed from the scan

Date: 2023-02-27 Institution: UKSH Lübeck, Germany Type: Second opinion
Source file (Google Drive, docs_eng/): UKSH_Luebeck_second_opinion_27.02.2023_EN.docx
Note: Scan and two cited publications: docs_eng/immunotherapy_suggestion/. Given for the leiomyosarcoma diagnosis, before the GIST re-diagnosis.

Links: English translation on Google Drive [hosted copy] (UKSH_Luebeck_second_opinion_27.02.2023_EN.docx) (Ukrainian original [hosted copy] (immunotherapy_suggestion/28.02.2023-Second Opinion-Z.A.-#8801.pdf))

Independent recommendation regarding further treatment options — UKSH Lübeck, 27.02.2023 (transcribed from the scan)

Source: docs_eng/immunotherapy_suggestion/28.02.2023-Second Opinion-Z.A.-#8801.pdf (one-page scan in English/German, Universitätsklinikum Schleswig-Holstein, Hochschulambulanz für Hämatologie/Onkologie, Klinik für Hämatologie und Onkologie Lübeck; Dr. med. Maxim Kebenko; case 223056425). Transcribed 11.09.2026.

8/2022 diagnosis of uterine leiomyosarcoma with hepatic and peritoneal metastases: cT2NxM1.

History of the disease: 9–12/2022 application of 4 courses of gemcitabine/docetaxel/avastine; 9/2022 [sic] start with pazopanib, development of PRES; 2/2023 application of Yondelis planned, after 3–4 cycles restaging.

27.2.23: Independent recommendation regarding further treatment options

Application of Yondelis if at least stable disease after 3–4 cycles.

If progression, the combination of doxorubicin plus DTIC should be considered — due to the better clinical data vs. doxorubicin mono.

Ifosfamide should be avoided showing negative impact on PFS (and probably OS) by leiomyosarcoma in some retrospective data analysis.

Off label but potentially efficient could be the combination nivolumab/ipilimumab showing some promising disease stabilizations.

ICD: C55 malignant neoplasm of the uterus, part unspecified. (Note: the diagnosis was revised to GIST in May 2023; the two attached publications in the same Drive folder are the references for the immunotherapy suggestion.)