<p>Clinical Outcome of Systemic Treatment for Advanced Soft Tissue Sarcoma: Real-Life Perspective in Japan</p>

Checkpoint inhibitor therapy has been shown to improve outcomes in multiple solid malignancies; however, data are limited in soft tissue sarcoma. We present two cases of patients with advanced soft tissue sarcoma of different subtypes (dedifferentiated liposarcoma and myxofibrosarcoma) with zero percent PD-L1 expression by immunohistochemistry who were treated with ipilimumab and nivolumab followed by maintenance nivolumab. Both patients had failed multiple lines of systemic treatment and experienced long-term remission after starting ipilimumab and nivolumab. Genetic testing revealed that no genetic mutations were found in common between the two cases. One patient received concurrent cryoablation, which may have sensitized his tumor to immunotherapy. Checkpoint inhibitor therapy may improve outcomes in soft tissue sarcoma regardless of PD-L1 status, especially when combined with cryoablation. Studies are needed to evaluate whether treatment response varies by sarcoma subtype and what molecular markers can be used to guide patient selection.

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Trabectedin Plus Radiotherapy for Advanced Soft-Tissue Sarcoma: Experience in Forty Patients Treated at a Sarcoma Reference Center

Cancers ◽

10.3390/cancers12123740 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3740

Author(s):

Nadia Hindi ◽

Irene Carrasco García ◽

Alberto Sánchez-Camacho ◽

Antonio Gutierrez ◽

Javier Peinado ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Therapeutic Option ◽

Symptomatic Relief ◽

Unmet Need ◽

Real Life ◽

Progression Free Survival ◽

Complete Response ◽

Growth Modulation ◽

Advanced Soft Tissue Sarcoma

Symptomatic control and tumoral shrinkage is an unmet need in advanced soft-tissue sarcoma (STS) patients beyond first-line. The combination of trabectedin and radiotherapy showed activity in a recently reported clinical trial in this setting. This retrospective series aims to analyze our experience with the same regimen in the real-life setting. We retrospectively reviewed advanced sarcoma patients treated with trabectedin concomitantly with radiotherapy with palliative intent. Growth-modulation index (GMI) was calculated as a surrogate of efficacy. Forty metastatic patients were analyzed. According to RECIST, there was one (2.5%) complete response, 12 (30%) partial responses, 18 (45%) disease stabilizations, and nine (22.5%) progressions. After a median follow-up of 15 months (range 2–38), median progression-free survival (PFS) and overall survival (OS) were 7.5 months (95% CI 2.8–12.2) and 23.5 months (95% CI 1.1–45.8), respectively. Median GMI was 1.42 (range 0.19–23.76), and in 16 (53%) patients, it was >1.33. In patients with GMI >1.33, median OS was significantly longer than in those with GMI 0–1.33 (median OS 52.1 months (95% CI not reached) vs. 8.9 months (95% CI 6.3–11.6), p = 0.028). The combination of trabectedin plus radiotherapy is an active therapeutic option in patients with advanced STS, especially when tumor shrinkage for symptomatic relief is needed.

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The clinical outcome of eribulin treatment in Japanese patients with advanced soft tissue sarcoma: a Tokai Musculoskeletal Oncology Consortium study

Clinical & Experimental Metastasis ◽

10.1007/s10585-019-09980-3 ◽

2019 ◽

Vol 36 (4) ◽

pp. 343-350 ◽

Cited By ~ 2

Author(s):

Tomoki Nakamura ◽

Satoshi Tsukushi ◽

Kunihiro Asanuma ◽

Hirohisa Katagiri ◽

Kunihiro Ikuta ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Clinical Outcome ◽

Japanese Patients ◽

Advanced Soft Tissue Sarcoma ◽

Musculoskeletal Oncology

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Advanced Soft Tissue Sarcoma: Systemic Treatment Patterns and Survival in Germany

Value in Health ◽

10.1016/j.jval.2016.09.2362 ◽

2016 ◽

Vol 19 (7) ◽

pp. A760 ◽

Cited By ~ 2

Author(s):

DS Mytelka ◽

M Lorenzo ◽

D Stafkey-Mailey ◽

Y D'Yachkova ◽

SP Nagar ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Systemic Treatment ◽

Treatment Patterns ◽

Advanced Soft Tissue Sarcoma

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Trabectedin for Patients with Advanced Soft Tissue Sarcoma: A Non-Interventional, Retrospective, Multicenter Study of the Italian Sarcoma Group

Cancers ◽

10.3390/cancers13051053 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1053

Author(s):

Emanuela Palmerini ◽

Roberta Sanfilippo ◽

Giovanni Grignani ◽

Angela Buonadonna ◽

Antonella Romanini ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Performance Status ◽

Objective Response ◽

Real Life ◽

Progression Free Survival ◽

Bone Marrow Toxicity ◽

Line Treatment ◽

Second Line ◽

Advanced Soft Tissue Sarcoma

The Italian Sarcoma Group performed this retrospective analysis of patients with advanced soft tissue sarcoma, pretreated with ≥1 anthracycline-based treatment, and treated with trabectedin every three weeks. Primary endpoint was to describe real-life use of trabectedin across Italy. Secondary endpoints included objective response rate (ORR) and safety. Overall, 512 patients from 20 Italian centers were evaluated. Leiomyosarcoma (37.7%)/liposarcoma (30.3%) were the most prevalent histological types (abbreviated as L-sarcoma). Patients received a median of four trabectedin cycles (range: 1–40), mostly as a second-line treatment (~60% of patients). The ORR was 13.7% superior (p < 0.0001) in patients with L-sarcoma compared with patients with non-L-sarcoma (16.6% vs. 9.0%). Median progression-free survival (PFS) was 5.1 months, whereas median overall survival (OS) was 21.6 months. Significantly better PFS and OS were observed in patients with L-sarcoma, those with objective responses and/or disease stabilization, treated in an early line and treated with reduced dose. Bone marrow toxicity (61.4%) and transaminase increases (21.9%) were the most common grade 3/4 adverse events. The results of this real-life study suggest that trabectedin is an active treatment, which is mostly given as a second-line treatment to patients with a good performance status and high-grade, metastatic L-sarcoma (clinical trial information: NCT02793050).

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Systemic treatment in advanced soft tissue sarcoma: what is standard, what is new

BMC Medicine ◽

10.1186/s12916-017-0872-y ◽

2017 ◽

Vol 15 (1) ◽

Cited By ~ 37

Author(s):

Anna Maria Frezza ◽

Silvia Stacchiotti ◽

Alessandro Gronchi

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Systemic Treatment ◽

Advanced Soft Tissue Sarcoma

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Trabectedin for advanced soft tissue sarcoma: Ten-year real-life perspective.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.11060 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 11060-11060 ◽

Cited By ~ 1

Author(s):

Sivan Shamai ◽

Ofer Merimsky

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Life Experience ◽

Real Life ◽

Previous Treatment ◽

Progression Free Survival ◽

Tumor Burden ◽

Rapid Progression ◽

Advanced Soft Tissue Sarcoma ◽

Significant Difference

11060 Background: Trabectedin is a marine - derived chemotherapy, which lately received FDA approval for use in anthracycline resistant advanced soft tissue sarcoma (STS), especially liposarcoma and leiomyosarcoma (L-sarcomas). Methods: We report our ten-year real-life experience with trabectedin, 1.5mg/m2/d c.i.v. q3w till progression, regarding safety and efficacy in a cohort of 86 patients (24-83y). Liposarcoma was the diagnosis in 46% , leiomyosarcoma in 43%. Results: A total of 703 cycles of Trabectedin were given, with a median of five cycles per patient (range 1-59). Median overall survival (mOS) was 11 months for liposarcoma patients (range 1-63), and 15 months for leiomyosarcoma patients (range 1-35). There was no statistically significant difference in progression free survival (PFS), when stratified according to previous treatment lines given. Trabectedin exhibited a favorable safety profile, with only 22% requiring dose reductions. Grade 3 and more toxicity were noted in 25% of the patients, mostly myelosuppression. There was no treatment related death. Conclusions: In contrast to former trials, our retrospective data represents real life experience with Trabectedin, and includes patients with diverse age, histology, performane status, prior treatments and tumor burden. The group includes 10 patients (11.6%) who received Trabectedin as first line (Either due to congestive heart failure or to rapid progression following adjuvant Doxorubicin and Ifosfamide), 10 patients (11.6%) were above age 70, nine (10.5%) had histologies other than liposarcoma or leiomyosarcoma, and 23 (26.7%) had ECOG PS of 2 or higher. Trabectedin is a safe and effective drug in advanced high grade STS. Further research is needed to identify which patients will benefit most.

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