We treat your tumor directly, through a needle, and adjust the immune drugs to your subtype where that is known. A physician reads your records first, free. For sarcoma that has spread, or stopped responding to standard treatment.
Complete a short, three-step form to begin your admissions process. One of our patient consultants will contact you to explain the process and guide you through the next steps.
Sarcomas differ, and few subtypes respond to IV immunotherapy. A needle breaks the tumor up, often with electrical pulses rather than heat, because sarcomas lie against vessels and nerves. The same needle injects immune drugs, adjusted to your subtype where that is known. It works alongside your current treatment, not in place of it.
The immune drugs placed in the tumor teach the immune system to recognize this cancer, the way a vaccine does. You teach the immune system in one spot, and it goes after the same cancer in the rest of the body.
The treated tumor is the source of the vaccine, and it keeps supplying it. It is not one exposure and done. Every round of tumor cells the immune system destroys exposes new antigens, and those restart the cycle, so the response keeps spreading: broader, throughout the body, and with memory. It turns a “cold” tumor, one the immune system ignores, “hot”.
Card 06 leads back to card 02. Doctors call the widening response epitope spreading.
Sarcomas grow deep in the abdomen, in the uterus, in limbs, in the chest wall, often against major vessels and nerves. Electrical pulses break up tumor cells without cooking the tissue around them, so we can treat there. About an hour; most people go home the same day.
Leiomyosarcoma, synovial sarcoma and GIST (a sarcoma of the stomach or bowel wall) are quiet to the immune system and rarely respond to checkpoint drugs alone. Breaking the tumor open exposes its markers. The drugs we inject are chosen to make the immune system respond.
About an hour under image guidance, and most people go home the same day, about two hours later.
Once the immune system has been alerted at one tumor and kept re-primed by the cycle above, it acts on spread in the lungs, liver or elsewhere that was never treated, and it remembers it.
Standard care. Localized sarcoma is treated with surgery, with or without radiation, and with neoadjuvant chemotherapy for high-grade tumors. Metastatic disease is treated with doxorubicin-based combinations, then subtype-specific agents; afamitresgene autoleucel (Tecelra), a T-cell receptor therapy, is used for MAGE-A4-positive synovial sarcoma. Pembrolizumab has activity only in selected histologies: undifferentiated pleomorphic sarcoma (UPS), dedifferentiated liposarcoma, alveolar soft-part sarcoma (ASPS) and Kaposi sarcoma. Leiomyosarcoma, synovial sarcoma and gastrointestinal stromal tumor (GIST) are immunologically "cold" (they rarely respond to a checkpoint inhibitor alone); for GIST, imatinib and the tyrosine kinase inhibitor sequence are the standard of care.
Ablation alone. Local control only. Thermal ablation is limited where a sarcoma lies against major vessels or nerves, which is common in the retroperitoneum, the extremities and the chest wall.
This approach. Image-guided ablation of a tumor (or, in oligometastatic disease, each site), followed by intratumoral immunotherapy injected into the ablation bed through the same access, with the agents chosen by subtype. For an immune-responsive subtype that has progressed on pembrolizumab, the aim is to extend or re-engage the response. For a cold subtype, the aim is to expose the tumor's antigens and make the immune system respond to it. For synovial sarcoma, WCI describes aiming to engage the cancer-testis antigens MAGE-A4 and NY-ESO-1 released by ablation. This combination is offered under physician review. In our clinical observations, a systemic (abscopal) effect occurs at untreated sites in the lung, liver or elsewhere. Bone sarcoma is within WCI's stated criteria (below); the procedure at a bone site, and the fracture-risk exclusion, are decided case by case and are not described step by step here.
The procedure, step by step
Agents. The injected immunotherapy is a multi-agent combination. The agents and doses are set per patient by the treating physician.
The immune conversion cycle, in clinical terms. Ablation disrupts the tumor and exposes its full antigen repertoire, not a pre-selected subset. The injected immunotherapy then remodels the tumor microenvironment, priming, recruiting and activating immune cells and releasing the brakes on them. Immune-mediated lysis exposes further antigens, which re-prime the response (epitope spreading), producing a broader, polyclonal, systemic response with memory, converting a cold tumor hot. This is WCI’s stated rationale, in Dr. Goodyear’s framing, borne out in our clinical observations.
Evidence. The published basis for intratumoral delivery is preclinical: in mice with colorectal tumors and no ablation, anti-CTLA-4 injected into a tumor reached about 14 times the day-7 level of intravenous dosing in that tumor; the untreated tumor received no more than with intravenous dosing, and half the dose reached the blood within an hour [1]. That is mouse data in colorectal cancer, not sarcoma; it does not test ablation and does not support a distant-site effect. No randomized trial of ablation plus intratumoral immunotherapy in sarcoma exists.
No sarcoma case with scans and a written record is on file yet. The patient accounts on this page are patients' own words, not medical records. Sources
Your subtype, and what has already been tried, decide where we fit. Pick the card that sounds like your diagnosis. Whether this is right for you is decided case by case, by a physician reading your pathology and scans, so none of these lists is a verdict. If you are unsure which card is yours, send the records.
Any of these describes you:
Each case is individually evaluated by the Williams Cancer Institute team.
After completing our admissions form, one of our Patient Consultants will contact you to explain the process and guide you through the next steps. Our admissions process is free of charge, including the review of your medical information and, if our medical team determines that you are a candidate, a video consultation. Treatments are generally not covered by health insurance, and WCI does not bill insurance companies.
One of our Patient Consultants will contact you to explain the admissions process, answer your general questions, and guide you through the next steps.
Your Patient Consultant will guide you on the required medical records and imaging studies, as well as how to submit them so our medical team can evaluate your case.
Once the necessary information has been received, our medical team will review your case to determine whether you may be a candidate for our treatments. If necessary, the medical team may request additional studies or information before making a decision.
If our medical team determines that you are a candidate, we will coordinate a complimentary Zoom consultation with one of our physicians. During this consultation, you will be able to discuss your case, address your medical questions, and learn about the treatment approach indicated for you.
Following your medical consultation, you will receive a personalized treatment plan that includes the corresponding costs. If you decide to proceed, the next steps will be coordinated to schedule your treatment.
Most treatments take place in Los Cabos, Mexico; in some cases our medical team may schedule a procedure in Mexico City. Rebyota is given only at our Beverly Hills, California location.
Your physician confirms the details for your case.
Your physician goes through the risks for your case before anything is decided.
Dr. Jason Williams is a board-certified radiologist who has spent his career putting needles into tumors under imaging. His first patent, in 2003, covered ablation combined with immunotherapy injected into the tumor. A physician since 2000, he opened his first ablation center in 2004 and completed his residency in 2007. He also co-founded Syncromune, whose separate investigational drug SV-102 holds FDA Fast Track status. His tumor board reviews every case.
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Most of our treatments are performed in Los Cabos, Mexico, in a private hospital setting.
Other treatment locations. In some cases our medical team may schedule a procedure in Mexico City. Rebyota is given only at our Beverly Hills, California location.
Accounts Williams Cancer Institute publishes, shared with each patient's permission. They span different cancers. Individual results vary and are not guaranteed.
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Read the full account →Complete our admissions form to get started. One of our Patient Consultants will contact you to explain the process and guide you through the next steps, including the medical information and imaging studies required for our medical team to evaluate your case.
