Metronomic continuous oral cyclophosphamide as second and further line in soft-tissue sarcomas (STS) of the adult.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10572-10572
Author(s):  
Alessandro Comandone ◽  
Antonella Boglione ◽  
Elena Giubellino ◽  
Paola Bergnolo ◽  
Giancarlo Gino ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Locally Advanced ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Oral Cyclophosphamide ◽  
Second Line ◽  
Good Tolerability ◽  
Free Survival ◽  
Heavily Pretreated ◽  
Third Line

10572 Background: In STS third line treatment is poorly defined. However many patients (pts), after aggressive therapy as first and second line progress in their disease ask to be treated. Oral cyclophosphamide (CPM) was already used in breast cancer, prostate cancer and in elderly pts with STS with favourable results. Aim of our study was to define the feasibility, tolerability and activity of oral CPM as third line and further line chemotherapy Methods: 45 pts (19 M; 26 F) with advanced or metastatic STS heavily pretreated were included. Oral CPM was given daily at total dose of 50 mg/day without interruption excepted for toxicity or progressive disease Results: Median age was 60 (32-81), histological subtypes were: leiomyosarcoma 12, liposarcoma 10, condrosarcoma 5, sinovialsarcoma 4, sarcoma NOS 4, other 10. Primary sites were: extremities 21, retroperitoneum 19, trunk 5. 41 pts were metastatic, 4 locally advanced. 41 pts were pretreated with chemotheraphy (15 were in II line, 17 in III line, 7 in IV line, 2 in V line). Median PS (ECOG) was 2 . Median duration of theraphy was 4 months (1-38). Progression free survival (PFS) ranged from 0 to 42+ months (median 4 months). Treatment was well tolerated, we registred only one episode of leucopenia G2 and one of asthenia G2. No complete responses were seen. Only 3 minimal responses and 18 stable disease were seen. Conclusions: Oral CPM showed a mild activity and good tolerability in advanced soft tissue and metastatic STS. It could be an appropriate solution as second line and further therapy and in unfit or elderly pts.

scholarly journals Preoperative Radiation Therapy Followed by Reexcision May Improve Local Control and Progression-Free Survival in Unplanned Excisions of Soft Tissue Sarcomas of the Extremity and Chest-Wall

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Hina Saeed ◽  
David M. King ◽  
Candice A. Johnstone ◽  
John A. Charlson ◽  
Donald A. Hackbarth ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Proportional Hazards Model ◽  
Performance Status ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Preoperative Radiation ◽  
Free Survival ◽  
Unplanned Excision

Background. The management for unplanned excision (UE) of soft tissue sarcomas (STS) has not been established. In this study, we compare outcomes of UE versus planned excision (PE) and determine an optimal treatment for UE in STS.Methods. From 2000 to 2014 a review was performed on all patients treated with localized STS. Clinical outcomes including local recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) were evaluated using the Kaplan-Meier estimate. Univariate (UVA) and multivariate (MVA) analyses were performed to determine prognostic variables. For MVA, Cox proportional hazards model was used.Results. 245 patients were included in the analysis. 14% underwent UE. Median follow-up was 2.8 years. The LR rate was 8.6%. The LR rate in UE was 35% versus 4.2% in PE patients (p<0.0001). 2-year PFS in UE versus PE patients was 4.2 years and 9.3 years, respectively (p=0.08). Preoperative radiation (RT) (p=0.01) and use of any RT for UE (p=0.003) led to improved PFS. On MVA, preoperative RT (p=0.04) and performance status (p=0.01) led to improved PFS.Conclusions. UEs led to decreased LC and PFS versus PE in patients with STS. The use of preoperative RT followed by reexcision improved LC and PFS in patients who had UE of their STS.

Gefitinib in second line treatment of metastatic or locally advanced synovial sarcoma expressing HER1: A phase II trial of EORTC Soft Tissue and Bone Sarcoma Group

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9517-9517 ◽  
Author(s):  
J. Blay ◽  
A. Le Cesne ◽  
J. Whelan ◽  
A. Van Oosterom ◽  
I. Ray-Coquard ◽  
...  
Keyword(s):  
Gene Expression ◽  
Soft Tissue ◽  
Primary Endpoint ◽  
Objective Response ◽  
Locally Advanced ◽  
Specific Inhibitor ◽  
Progression Free Survival ◽  
Bone Sarcoma ◽  
Free Survival ◽  
Best Response

9517 Background: Synovial sarcomas (SyS) have been reported to overexpress HER1 in gene expression profile experiments and immunohistochemistry. Gefitinib, a specific inhibitor of HER1, was therefore tested in advanced or metastatic SyS failing doxorubicin (Doxo) ± ifosfamide (Ifo). Methods: Patients (pts) with advanced or metastatic SyS expressing HER1 using IHC were included. The principal inclusion criterias were: disease not curable with surgery and/or radiation, presence of a measurable progressive lesion(s), pretreatment with 1–3 line of chemotherapy in metastatic phase, ECOG PS 0 to 2, age ≥18 years. Gefitinib was given at 500mg/day until progression or intolerance. Primary endpoint was the rate of progression free survival at 3 months. A two step Simon design was used with a p0 of 25% and a p1 of 45%, with α and β of 0.1. 44 patients were scheduled to be recruited. Results: Between 10/02 and 10/05, 48 pts were included in 12 EORTC STBSG centers, 27 (56%) males and 21 (44%) females. Median age was 42 years (range 19–66). Metastatic sites were lung in 92% and soft tissue or lymph nodes in 42%, of the patients. Respectively 42, 40 and 18% of the patients had received 1, 2 and >2 lines of CT. As of December 2005, 37 pts are evaluable for toxicity and 39 for the primary endpoint. Median treatment duration was 11 weeks (range 2–25). Toxicity (G1–4) reported included fatigue (43%), diarrhea (54%), cough (35%), dyspnea (43%), cutaneous (73%). G3–4 toxicities were dyspnea (9), fatigue (4), cutaneous (2), cough (1), neurological (2), thombosis (2), hypoxia (1), infection (1). There was no drug related death. No dose reduction has been reported so far, but treatment had to be temporarily interrupted in 23% of the patients. As of December 2005, there were no objective response reported. Seven (18%) pts achieved stable disease as best response. At 3 months, 5 of the 39 (13%) evaluable patients achieved PFS; 6 and 12 months PFS were 10% and 3% respectively. Conclusions: 13% of SyS expressing HER1 achieved prolonged progression free survival at least 12 weeks) with gefitinib. Gene expression profiling and protein expression were not accurate predictors of gefitinib activity in this model. No significant financial relationships to disclose.

Treatment of metastatic colorectal cancer (mCRC) according to age.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 49-49
Author(s):  
Laura Ortega ◽  
Gabriela Torres Pérez-Solero ◽  
Marta Arregui Valles ◽  
Manuel Alva Bianchi ◽  
Inmaculada Aparicio Salcedo ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Event Rate ◽  
Young Patients ◽  
Progression Free Survival ◽  
Adverse Event Rate ◽  
Second Line ◽  
First Line ◽  
Old Patients ◽  
Free Survival ◽  
Third Line

49 Background: Elderly patients with mCRC are underrepresented in clinical trials. For this reason, the optimal treatment in this population is uncertain. The aim of this study is to compare efficacy and safety outcomes in patients with mCRC treated in our institution according to age (<65 vs ≥65 years). Methods: We conducted a retrospective analysis of 482 patients with mCRC attended in the Hospital Gregorio Marañón (Spain) between January 2010 and 2018. Results: Patients characteristics table. First-line: chemotherapy (CT) 98.7% vs 97.3% respectively (p=0.324), biologic agents (BA) 81.2% vs 79.0% (p=0.585). Significantly more <65-year-old patients received FOLFOX (60.5% vs 44.4%) and more ≥65-year-old patients XELOX (9.2% vs 17.5%) or capecitabine (2.0% vs 7.5%). Second-line: CT 64.9% vs 63.5% (p=0.764), BA 60.4% vs 51.1% (p=0.055). Significantly more <65-year-old patients received FOLFIRI (67.0% vs 54.5%) and more ≥65-year-old patients irinotecan (2.0% vs 8.6%). Third and subsequent lines: Significantly more young patients received a third-line (CT: 41.6% vs 31.0%; BA: 24% vs 21.6%), fourth-line (CT: 22.1% vs 11.9%; BA:16.2% vs 6.4%) and fifth-line of treatment (CT: 11.7% vs 5.8%; BA: 4.5% vs 3.6%). More young patients underwent metastasis resection (74.0% vs 58.1%, p=0.001). There were no differences in rate of post-operative complications (p=0.840). There were no differences in overall survival (36.05m vs 28.06, p=0.142), progression-free-survival (first-line: 12.73m vs 11.78m, p=0.139; second-line: 8.78m vs 62.71m, p=0.254) or adverse event rate (73.4% vs 73.6%, p=0.967). Conclusions: Intensive treatment could be an effectiveness and safe option in selected elderly patients. [Table: see text]

Effects of the sequential administration of GEMOX followed by FOLFIRI in cholangiocarcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 348-348
Author(s):  
Sihem Sebbagh ◽  
Chantal Dreyer ◽  
Armand De Gramont ◽  
Olivia Hentic ◽  
Pascal Hammel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Median Number ◽  
Severe Toxicity ◽  
Second Line ◽  
First Line ◽  
Free Survival ◽  
Sequential Administration

348 Background: Advanced cholangiocarcinoma are benefiting from platinum-based therapy (Valle et al, NEJM) but no validated option is available as second line systemic therapy. Methods: Objective : Explore the effect of 2 consecutive lines of chemotherapy in patients with cholangiocarcinoma fitted to receive sequential administration of received gemcitabine and oxaliplatin (GEMOX) followed by FOLFIRI. A retrospective study was conducted among patients who received GEMOX in first line followed by FOLFIRI in second line from January 2005 and September 2013 at Beaujon hospital (France). Overall survival, progression free survival and prognostic factors were determined by the Kaplan-Meier method and univariate analysis. Results: Thirty-four patients were included in the cohort. Eighteen patients (53%) presented intrahepatic cholangiocarcinoma (ICC) and 16 (47%) presented extrahepatic cholangiocarcinoma (ECC). At diagnosis, tumors were localized in 4 patients (12%), locally advanced in 13 patients (38%) and metastatic in 17 patients (50%). Among 10 patients with prior surgery, 7 received GEMOX adjuvant chemotherapy. The median overall survival time was 20.6 months in all patients and 17.1 months in patients who received GEMOX followed by FOLFIRI in the advanced setting. The median first line progression-free survival (PFS) was 5.7 months with a median number of 8 cycles of GEMOX. The median second line PFS was 2.9 months with a median number of 5 cycles of FOLFIRI. Patients who received >8 cycles of GEMOX in first line survived longer than those who received ≤ 8 cycles (23.1 vs 15.1 months; hazard ratio (HR) 5.22, P=0.009). The PFS of second line FOLFIRI was not different in patients who received more than 8 cycles of GEMOX (HR=1.72 P=0.26). Univariate analysis showed no correlation between age, sex, localization of primary, stage, and surgery with overall survival. No severe toxicity was reported related to GEMOX-FOLFIRI sequential combination in this study. Conclusions: Sequential administration of GEMOX followed by FOLFIRI is feasible for fitted patients with cholangiocarcinomas, yielding overall survival over 1 year.

scholarly journals Fourteen-Day Gemcitabine-Docetaxel Chemotherapy Is Effective and Safer Compared to 21-Day Regimen in Patients with Advanced Soft Tissue and Bone Sarcoma

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1983
Author(s):  
Minggui Pan ◽  
Maily K. Trieu ◽  
Manpreet Sidhu ◽  
Jeanette Yu ◽  
Tiffany Seto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Bone Sarcoma ◽  
Deletion Mutation ◽  
Similar Response ◽  
Kaiser Permanente ◽  
Free Survival ◽  
Entire Cohort ◽  
Cdkn2a Deletion

Gemcitabine-docetaxel (G-D) combination is an effective chemotherapy for patients with advanced soft tissue and bone sarcoma, first developed with G administered on days 1 and 8, and D on day 8 every 21 days and later modified to be administered every 14 days in 2012. The 14-day regimen has become increasingly adopted. However, its efficacy and toxicities have not been compared. We identified 161 patients with metastatic or locally advanced soft tissue and bone sarcoma treated with either a 14-day or 21-day regimen within Northern California Kaiser Permanente from 1 January 2017 to 30 July 2020 and compared the outcomes and toxicity profiles of patients treated with the either regimen. Seventy-nine (49%) and 82 (51%) patients received the 14-day and the 21-day regimen, respectively, with similar response rate (22.8% and 15.8%, p = 0.26), median progression-free survival (PFS, 4.0 and 3.2 months, p = 0.15), and median overall survival (OS, 12.6 and 14.7 months, p = 0.55). Subset analysis of the untreated patients (approximately 60% of the entire cohort) as well as the patients with leiomyosarcoma only (approximately 50% of the entire cohort) showed that OS was not significantly different between the two regimens. Febrile neutropenia requiring hospitalization occurred in 10 and one patients (p = 0.006) and intolerance leading to discontinuation of chemotherapy occurred in 12 and two patients (p = 0.006) treated with the 21-day and the 14-day regimens, respectively. CDKN2A deletion/mutation or CDK4 amplification was associated with worse median OS (p = 0.06), while a RB1 deletion/mutation was associated with better median PFS (p = 0.05), and these two genomic alterations were mutually exclusive. Our data demonstrate that, compared to the traditional 21-day G-D regimen, the 14-day G-D regimen is equally effective but safer. In addition, CDKN2A and RB1 pathways play significant role on the outcomes of the patients.

scholarly journals Advanced dermatofibrosarcoma protuberans: an updated analysis of cases from an Indian sarcoma clinic

2021 ◽  
pp. FSO743
Author(s):  
Azgar A Rasheed ◽  
Adarsh Barwad ◽  
Ekta Dhamija ◽  
Rakesh Garg ◽  
Rambha Pandey ◽  
...  
Keyword(s):  
Response Rate ◽  
Locally Advanced ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Dermatofibrosarcoma Protuberans ◽  
First Line ◽  
Free Survival ◽  
Median Progression Free Survival ◽  
Sarcomatous Transformation ◽  
Relative Rarity

Aim: Dermatofibrosarcoma protuberans (DFSP) accounts for less than 2% of all soft-tissue sarcomas. Patients & methods: We retrospectively reviewed our database for patients with locally advanced or metastatic DFSP who had presented to our clinic between January 2016 and January 2020. Results: We identified a total of 14 patients, of whom ten had sarcomatous transformation. Eleven cases had metastatic disease and three were locally advanced. The initial partial response rate to first-line imatinib was 76.9% and the overall median progression-free survival on imatinib was 15 months. Conclusion: We had a high proportion of patients with sarcomatous transformation, in contrast to their relative rarity in the West. While most patients had initial good responses to imatinib, second-line therapies were not as effective.

Pazopanib for metastatic soft-tissue sarcoma: A multicenter retrospective study

2020 ◽  
pp. 107815522092407
Author(s):  
Sinan Koca ◽  
Mehmet Beşiroğlu ◽  
Melike Özçelik ◽  
Mustafa Karaca ◽  
Mehmet Bilici ◽  
...  
Keyword(s):  
Overall Survival ◽  
Weight Loss ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Kinase Inhibitor ◽  
Single Agent ◽  
Real Life ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Free Survival

Purpose Soft tissue sarcomas are associated with a poor prognosis and low chemotherapeutic efficiency. Pazopanib is an orally available multi-tyrosine kinase inhibitor that was explored in patients with non-adipocytic advanced soft tissue sarcomas. The aim of this retrospective study was to evaluate the real life data of single-agent pazopanib efficacy and safety for soft tissue sarcomas in the Turkish population. Materials and methods We evaluated a total of 103 patients (41 males, 62 females) who received pazopanib for advanced non-adipocytic soft tissue sarcomas diagnosis in eight centers of Turkey, retrospectively. The pazopanib dose was 800 mg once daily. Progression-free survival, overall survival, and adverse events were analyzed. Results The median age was 50 years (range, 38–58). Majority of the patients had leimyosarcoma (41%). Median progression-free survival was 4.3 months, and the median overall survival was 10.1 months. The main common toxicities were fatigue, anorexia, weight loss, nausea, hypertension, and grade ≥3 toxicities were fatigue, anorexia, weight loss, and liver disorder. Conclusion Pazopanib is an efficient and tolerable agent and is well tolerated in good performance status patients with relapsed, advanced non-adipocytic soft tissue sarcomas.

scholarly journals Leiomyosarcoma of the Inferior Vena Cava: A Case Report of Complete and Sustained Response with Trabectedin

2016 ◽  
Vol 29 (4) ◽  
pp. 284 ◽  
Author(s):  
André Cruz ◽  
Luís Bretes ◽  
Carlos Reis ◽  
Irene Furtado
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Radical Resection ◽  
Sustained Response ◽  
Free Survival ◽  
Vascular Origin ◽  
Third Line

<p>Inferior vena cava leiomyosarcoma is a very rare tumor, accounting for only 0.5% of all soft tissue sarcomas. As the other leyomiosarcomas of vascular origin, they have a poor prognosis, and radical resection with surgical margins free of tumor is the only potentially curative treatment. We present a case of a 46 year-old woman with metastatic inferior vena cava leiomyosarcoma who progressed after anthracyclines and ifosfamide and achieved a complete and sustained response with trabectedin. Beyond progression, the patient started third line treatment with pazopanib. A brief review of literature is also given. This case supports the efectiveness of a recent therapeutic agent, with an impressive progression-free survival in a recurrent metastatic inferior vena cava leiomyosarcoma.</p>

scholarly journals Efficacy and Safety of Trabectedin in Patients with Soft Tissue Sarcoma: A Bicentric Retrospective Analysis.

2021 ◽  
Author(s):  
Chaigneau Loïc ◽  
Jary Marine ◽  
Nerich Virginie ◽  
Hervieu Alice ◽  
Aubry Sébastien ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Progression Free Survival ◽  
Myxoid Liposarcoma ◽  
Free Survival ◽  
Median Progression Free Survival ◽  
Heterogenous Group ◽  
End Of Treatment ◽  
Low Toxicity

Abstract Background: Soft tissue sarcomas (STS) are a rare and heterogenous group of tumors, with poor prognostic, judging from their frequency to relapse. Few drugs are available. Since 2007, trabectedin got approval after failure of anthracyclines and ifosfamide, for advanced or metastatic STS.Patients and Methods: This retrospective study describes effects of trabectedin on survival, response, and toxicity, in STS patients. One hundred twenty-nine patients treated between 2002 and 2019 were analysed, from two French centers. All patients were tested for toxicities, and efficacy was assessed in patients exposed to at least 2 cycles of trabectedin.Results: Three median cycles were administered per patient (1-79). Among the 115 patients analysed for efficacy, the median progression free survival was 3.0 months [CI95%: 2.3 – 4.7], with an overall survival of 11.9 months [CI95%: 10.2 – 16.6]. The rate of disease control was 45.2% at the end of treatment. Myxoid liposarcoma (n = 11) was the histology subtype that benefited most from this chemotherapy with median progression free survival and an overall survival of 13.3 months [CI95%: 2.3 – 18.7] and 27.8 months [CI95%: 3.2 – 64.7], respectively. Adverse events were manageable. Conclusion: Efficacy of trabectedin is confirmed in terms of clinical benefit and low toxicity, especially for myxoid liposarcoma.

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