ABSTRACT
INTRODUCTION: The effectiveness of trabectedin for the treatment of leiomyosarcoma and liposarcoma (commonly referred to as L-sarcomas) has been widely evidenced in clinical trials and real-world studies. Nevertheless, available literature on non-L-sarcomas is less abundant. The objective of the present study is to evaluate the effectiveness and safety of trabectedin in a cohort of patients with non-L-sarcomas in the real-world setting. METHODS: This retrospective, observational study included 34 patients who received trabectedin in the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) between October 2013 and July 2020. RESULTS: The most frequent histologic subtypes were undifferentiated spindle cell/pleomorphic sarcoma (n = 11, 32.4%), synovial sarcoma (n = 6, 17.7%), myxofibrosarcoma (n = 5, 14.7%), and malignant peripheral nerve sheath tumor (n = 4, 11.8%). The mean number of cycles with trabectedin was 5.5 (range 2-28). Three patients achieved partial response (8.8%) and eight patients showed stable disease (23.5%). The objective response rate and disease control rate were 8.8% (95% confidence interval (CI), 95% CI 1.9-23.7) and 32.4% (95% CI 17.4-50.5), respectively. Overall, progression-free survival was 2.9 months (95% CI 2.1-3.4). The overall survival was 7.3 months (95% CI 4.7-12.8). The most common trabectedin-related grade 3 adverse events were observed in 10 patients (26.5%), mostly being neutropenia (14.7%) and elevated transaminases (5.9%), whereas one patient (2.9%) reported grade 4 febrile neutropenia that required hospitalization. CONCLUSIONS: The findings of this real-life study consistently support that trabectedin is an effective and safe option for the treatment of patients with non-L-sarcoma after failure of anthracyclines and ifosfamide, or in patients who are unsuited to receive these agents.
Subject(s)
Sarcoma , Soft Tissue Neoplasms , Tetrahydroisoquinolines , Adult , Antineoplastic Agents, Alkylating/adverse effects , Dioxoles/adverse effects , Humans , Retrospective Studies , Sarcoma/drug therapy , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/pathology , Tetrahydroisoquinolines/therapeutic use , Trabectedin/therapeutic useABSTRACT
La quimioterapia neoadyuvante (QTN) es el tratamiento de elección en las pacientes con cáncer de mama localmente avanzado e inflamatorio. Los objetivos de este tratamiento son mejorar las opciones quirúrgicas (convertir tumores inoperables en operables, así como obtener mejores resultados estéticos), determinar la respuesta a la quimioterapia (respuesta patológica completa [pCR, en sus siglas en inglés]) y aumentar la supervivencia libre de enfermedad. La QTN es una situación clínica ideal para investigar predictores moleculares de respuesta, predecir los pacientes que conseguirán una pCR y los pacientes con un pronóstico favorable, aunque no alcancen una pCR. Los estudios actuales definirán mejor el esquema óptimo de quimioterapia (nuevos fármacos) y los pacientes que más se beneficiarán de este tratamiento(AU)
Neoadjuvant systemic therapy (NST) has become widely accepted as the treatment of choice for patients with locally advanced and inflammatory breast cancer. In general, NST is used to improve the surgical options (induction of tumour shrinkage that may render inoperable tumours amenable to surgery and may allow smaller resection and better cosmetic outcome for patients with operable tumours), to determine the response to NST (pCR: pathologic complete response), and to obtain long-term disease-free survival. NST is an ideal clinical setting to discover molecular predictors of response to therapy, to predict patients who will achieve a pCR, and patients who will have a favourable prognosis despite not achieving a pCR. Current trials will better define the optimal NST (new drugs) and those patients who might best benefit from this therapy(AU)
