Publicaciones científicas

Efficacy of second and third lines of treatment in advanced soft tissue sarcomas: a real-world study

17-jun-2023 | Revista: Clínical & Translational Oncology

Laura Gutierrez-Sainz #  1 , Sara Martinez-Fdez #  2 , Jorge Pedregosa-Barbas  2 , Jesus Peña  2 , Maria Alameda  2 , David Viñal  2 , Julia Villamayor  2 , Sergio Martinez-Recio  2   3 , Pablo Perez-Wert  2 , Ana Pertejo-Fernandez  2 , Alejandro Gallego  2   4 , Virginia Martinez-Marin  2   5 , Pilar Zamora  2   5   6 , Enrique Espinosa  2   5   6   7 , Marta Mendiola  7   8 , Jaime Feliu  2   5   6   7 , Andres Redondo  9   10   11

Background: Soft tissue sarcomas (STSs) are an uncommon and heterogeneous group of tumours. Several drugs and combinations have been used in clinical practice as second-line (2L) and third-line (3L) treatment. The growth modulation index (GMI) has previously been used as an exploratory efficacy endpoint of drug activity and represents an intra-patient comparison.

Methods: We performed a real-world retrospective study including all patients with advanced STS who had received at least 2 different lines of treatment for advanced disease between 2010 and 2020 at a single institution. The objective was to study the efficacy of both 2L and 3L treatments, analysing the time to progression (TTP) and the GMI (defined as the ratio of TTP between 2 consecutive lines of therapy).

Results: Eighty-one patients were included. The median TTP after 2L and 3L treatment was 3.16 and 3.06 months, and the median GMI was 0.81 and 0.74, respectively. The regimens most frequently used in both treatments were trabectedin, gemcitabine-dacarbazine, gemcitabine-docetaxel, pazopanib and ifosfamide. The median TTP by each of these regimens was 2.80, 2.23, 2.83, 4.10, and 5.00 months, and the median GMI was 0.78, 0.73, 0.67, 1.08, and 0.94, respectively. In terms of histotype, we highlight the activity (GMI > 1.33) of gemcitabine-dacarbazine in undifferentiated pleomorphic sarcoma (UPS) and in leiomyosarcoma, pazopanib in UPS, and ifosfamide in synovial sarcoma.

Conclusions: In our cohort, regimens commonly used after first-line STS treatment showed only slight differences in efficacy, although we found significant activity of specific regimens by histotype.

CITA DEL ARTÍCULO  Clin Transl Oncol. 2023 Jun 17.doi: 10.1007/s12094-023-03221-6