Faculty Opinions recommendation of Growth modulation index as metric of clinical benefit assessment among advanced soft tissue sarcoma patients receiving trabectedin as a salvage therapy.

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.

Download Full-text

A Growth Modulation Index-Based GEISTRA Score as a New Prognostic Tool for Trabectedin Efficacy in Patients with Advanced Soft Tissue Sarcomas: A Spanish Group for Sarcoma Research (GEIS) Retrospective Study

Cancers ◽

10.3390/cancers13040792 ◽

2021 ◽

Vol 13 (4) ◽

pp. 792

Author(s):

Javier Martínez-Trufero ◽

Luis Miguel De Sande-González ◽

Pablo Luna ◽

Javier Martin-Broto ◽

Rosa Álvarez ◽

...

Keyword(s):

Overall Survival ◽

Soft Tissue ◽

Prognostic Score ◽

Soft Tissue Sarcomas ◽

High Growth ◽

Modulation Index ◽

Time To Progression ◽

Growth Modulation ◽

Advanced Soft Tissue Sarcoma ◽

Prognostic Tool

The aim of this study was to identify an easily reliable prognostic score that selects the subset of advanced soft tissue sarcoma (ASTS) patients with a higher benefit with trabectedin in terms of time to progression and overall survival. A retrospective series of 357 patients with ASTS treated with trabectedin as second- or further-line in 19 centers across Spain was analyzed. First, it was confirmed that patients with high growth modulation index (GMI > 1.33) were associated with the better clinical outcome. Univariate and multivariate analyses were performed to identify factors associated with a GMI > 1.33. Thus, GEISTRA score was based on metastasis free-interval (MFI ≤ 9.7 months), Karnofsky < 80%, Non L-sarcomas and better response in the previous systemic line. The median GMI was 0.82 (0–69), with 198 patients (55%) with a GMI < 1, 41 (11.5%) with a GMI 1–1.33 and 118 (33.1%) with a GMI > 1.33. The lowest GEISTRA score showed a median of time-to-progression (TTP) and overall survival (OS) of 5.7 and 19.5 months, respectively, whereas it was 1.8 and 3.1 months for TTP and OS, respectively, for the GEISTRA 4 score. This prognostic tool can contribute to better selecting candidates for trabectedin treatment in ASTS.

Download Full-text

Clinical benefit of eribulin (Halaven®) in the treatment of advanced soft tissue sarcoma patients and the novel anti-tumor mechanisms

Folia Pharmacologica Japonica ◽

10.1254/fpj.148.329 ◽

2016 ◽

Vol 148 (6) ◽

pp. 329-333

Author(s):

Noriyuki Koyama ◽

Shigeru Taniguchi ◽

Kotaro Kodama ◽

Osamu Tohyama ◽

Hiroki Hasegawa ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Clinical Benefit ◽

The Novel ◽

Advanced Soft Tissue Sarcoma

Download Full-text

Clinical Benefit of Second-Line Palliative Chemotherapy in Advanced Soft-Tissue Sarcoma

Sarcoma ◽

10.1155/2010/264360 ◽

2010 ◽

Vol 2010 ◽

pp. 1-8 ◽

Cited By ~ 16

Author(s):

Anna Minchom ◽

Robin L. Jones ◽

Cyril Fisher ◽

Omar Al-Muderis ◽

Sue Ashley ◽

...

Keyword(s):

Multivariate Analysis ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Disease Control ◽

Clinical Benefit ◽

Lung Metastases ◽

Second Line ◽

Advanced Soft Tissue Sarcoma ◽

Second Line Chemotherapy ◽

Line Chemotherapy

Background. This paper aimed to assess the utility of second-line chemotherapy in patients with advanced soft-tissue sarcoma.Materials and Methods. A retrospective search of a prospectively maintained database identified patients treated between 1991 and 2005. Patients with gastrointestinal stromal tumours, small round cell tumours, and Ewing's sarcoma were excluded. Response was assessed using WHO and RECIST. Patients who achieved stable disease for 6 months or more were classified as having disease control.Results. Three hundred and seventy-nine patients received second-line chemotherapy. Eighty-six (22.7%) achieved disease control. Median duration of response was 11 months (95% CI: 9–13). On multivariate analysis, pathological subtype, absence of lung metastases, and the use of combination chemotherapy were independent predictors of disease control. Twenty-eight (16.1%) patients who failed to respond to first-line therapy achieved disease control. Eight (2.1%) patients had sufficient downstaging to enable complete surgical resection. Progression-free survival was 23% at 6 months. Median overall survival was 8 months (95% CI: 7–10 months). On multivariate analysis, synovial histology and absence of lung metastases were associated with improved survival.Conclusion. Second-line chemotherapy can provide clinical benefit in over 20% of soft-tissue sarcoma patients.

Download Full-text