scholarly journals Next frontiers in systemic therapy for soft tissue sarcoma

2018 ◽  
Vol 7 (4) ◽  
pp. 43-43 ◽  
Author(s):  
Cheuh-Chuan Yen ◽  
Tom Wei-Wu Chen
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy

scholarly journals Update on Systemic Therapy for Advanced Soft-Tissue Sarcoma

2020 ◽  
Vol 27 (11) ◽  
pp. 25-33 ◽  
Author(s):  
A. Smrke ◽  
Y. Wang ◽  
C. Simmons
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy ◽  
English Language ◽  
Standard Of Care ◽  
Current Evidence ◽  
First Line ◽  
First Line Therapy

Background: Soft-tissue sarcoma (sts) represents a rare group of mesenchymal neoplasms comprising more than 50 heterogeneous subtypes. Great efforts have been made to increase the understanding of the treatment of advanced sts (unresectable or metastatic disease). We set out to determine whether outcomes for patients with advanced sts have improved over time and to assess the current evidence for systemic therapy. Methods: In a scoping review, we evaluated the contemporary evidence for systemic treatment of advanced sts in adults (>18 years of age). Phase i, ii, and iii studies of systemic therapy for advanced sts published in the English language were included. After abstract and full-text review of seventy-seven studies, sixty-two trials met the inclusion criteria. Results: The number of clinical trials conducted and published in advanced sts has increased over the last 30 years. Although median overall survival has increased, attempts at improving first-line therapy through dose intensification, doublet chemotherapy, or alternative backbones have not been successful. The optimal therapy beyond anthracyclines remains a challenge, especially given the heterogeneity that grouping multiple sts subtypes within clinical trials creates. However, increasing numbers of agents are being studied, and several studies had shown isolated benefit in progression-free or overall survival. Summary: First-line systemic therapy with an anthracycline remains the standard of care for advanced sts. However, choice of subsequent therapy beyond anthracyclines remains challenging. Novel systemic therapies, use of molecular diagnostics to direct therapy, subtype-specific trials, and learnings from real-world retrospective data are all important for improving outcomes in patients with advanced sts.

Advanced soft-tissue sarcoma in patients over age 75: Patterns of care and survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10057-10057
Author(s):  
Delphine Garbay Decoopman ◽  
Mary Louise Keohan ◽  
Angela Cioffi ◽  
Robert G. Maki ◽  
Binh Bui Nguyen ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy ◽  
Performance Status ◽  
Single Agent ◽  
Progression Free Survival ◽  
Advanced Soft Tissue Sarcoma ◽  
Optimal Care ◽  
Entire Cohort

10057 Background: There are no data regarding the management and the outcome of elderly patients (pts) diagnosed with advanced soft-tissue sarcoma (STS). Methods: The charts of pts aged ≥ 75 years and diagnosed with metastatic and/or unresectable STS between 1990 and 2011 at Memorial Sloan Kettering (New York) and Institut Bergonié (Bordeaux, France) were reviewed. Results: 189pts were included.Median age was 79 years (range 75-93).160 pts (84.5%) had metastatic disease. The most frequent histological subtype was leiomyosarcoma (n=57, 30%). The median age-adjusted Charlson comorbidity score was 10 (range 5-17). 120 pts (63.5%) received systemic therapy whereas 69 pts (36.5%) were managed with best supportive care (BSC) only. Pts who received BSC only were more likely ≥ 80 years old (58% versus 38%, p=0.01) and with performance status (PS) ≥ 2 (35% versus 14%, p=0.01). Single agent and combination therapy were delivered in 87 (72.5%) and 33 (27.5%) cases respectively. 67 pts (56%) received a 1st-line anthracycline-containing regimen. The median progression-free survival of pts treated with systemic therapy was 4 months (95% CI: 2.5-5.5). 21 pts (17.5%) had to stop 1st line treatment because of toxicity. On multivariate analysis, age ≥ 80 years, PS ≥ 2, and single-agent therapy were significantly associated with poor PFS. 51 pts received one or more further lines of therapies. At the time of analysis, 170 pts (90%) had died. 96% of deaths were related to the disease. The median OS for the entire cohort of pts was 9.6 months (95% CI: 7.3-12). The 1-year and 2-year OS rates were 43% (95% CI: 36–50), and 22% (95% CI: 16–28), respectively. The median OS of pts managed with systemic therapy and BSC were 12.5 months (95% CI: 8.4-16.6) and 5.1 months (95% CI: 3.7-6.5), respectively (p=0.02). However, on multivariate analysis, PS ≥ 2 and age-adjusted Charlson score ≥ 10 were the sole independent factors significantly associated with OS. Conclusions: A high proportion of elderly pts with advanced STS were considered unfit for chemotherapy. The OS of STS pts ≥ 75 years who were managed with systemic therapy seems similar to that of younger pts. Further efforts are needed to better define the optimal care for fit and unfit elderly pts with advanced STS.

scholarly journals PCN500 REAL-WORLD TREATMENT PATTERNS AND OUTCOMES FOR PATIENTS WITH ADVANCED SOFT TISSUE SARCOMA RECEIVING SYSTEMIC THERAPY IN BRAZIL

2019 ◽  
Vol 22 ◽  
pp. S534-S535
Author(s):  
A.C. Melo ◽  
P.X. Santi ◽  
D.L. Nunes ◽  
S.B. Aleixo ◽  
C.L. Martins ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Real World ◽  
Systemic Therapy ◽  
Treatment Patterns ◽  
Advanced Soft Tissue Sarcoma

scholarly journals Real-World Outcomes of Advanced Soft Tissue Sarcoma Patients Treated with Pazopanib

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Fawaz A ◽  
◽  
Shim I ◽  
Tilley D ◽  
Kelaney MR ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Real World ◽  
Systemic Therapy ◽  
Kinase Inhibitor ◽  
Advanced Soft Tissue Sarcoma ◽  
Clinical Trial Setting ◽  
Trial Setting

Background: Pazopanib is an oral multitarget tyrosine kinase inhibitor that is currently approved for the treatment of select subtypes of advanced Soft Tissue Sarcoma (STS) in patients who have progressed on prior anthracyclinebased chemotherapy regimens. In this study, we examine data from multiple centers to assess the efficacy of pazopanib in practice outside of a clinical trial setting. Methods: A retrospective chart analysis was conducted for pre-treated, advanced soft tissue sarcoma patients who began treatment with pazopanib in Alberta, Canada and Cairo, Egypt (2012-2018). Results: In total, 39 predominantly male (56.4%) patients received pazopanib. The median age was 51, 67% of whom had an ECOG of one or less. The predominant sarcoma subtype was leiomyosarcoma (30.8%), and all patients had received at least one prior line of systemic therapy. Thirtytwo of the 39 patients (82%) were initially given the full dose of 800mg with a median time on treatment of 116 days. Seven of the 39 (18%) patients required a dose reduction while on treatment. A majority (94.9%) of patients ultimately discontinued pazopanib treatment for reasons including death (21.6%), disease progression (62.2%), and toxicity (16.4%). The median progression-free and overall survival for these patients was 4.1 months (95%CI, 3.6-4.5) and 8.4 months (95% CI, 4.3-12.5), respectively. Conclusion: Pazopanib is an efficient and generally well-tolerated oral systemic therapy for the treatment of advanced, pre-treated, non-adipocytic soft tissue sarcoma. These results show the efficacy of pazoponib outside of a clinical trial setting.

scholarly journals Systemic Therapy in Pediatric-Type Soft-Tissue Sarcoma

2020 ◽  
Vol 27 (11) ◽  
pp. 6-16
Author(s):  
K.M. Ingley ◽  
S. Cohen-Gogo ◽  
A.A. Gupta
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Alternative Treatment ◽  
Systemic Therapy ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Targeted Agents ◽  
Soft Tissue Tumours ◽  
Cooperative Approach ◽  
Multi Agent

Soft-tissue sarcoma (sts) is rare and represents approximately 7% of cancers in children and in adolescents less than 20 years of age. Rhabdomyosarcoma (rms) is most prevalent in children less than 10 years of age and peaks again during adolescence (16–19 years of age). Multi-agent chemotherapy constitutes the mainstay of treatment for rms. In other non-rhabdomyosarcoma soft-tissue tumours, such as synovial sarcoma, evidence for routine use of chemotherapy is less robust, and alternative treatment options, including targeted agents and immunotherapy, are being explored. In this review, we focus on chemotherapy for pediatric-type rms and discuss the advances and challenges in systemic treatment for select non-rhabdomyosarcoma soft-tissue tumours in children and adolescents. We support an increasingly cooperative approach for treating pediatric and adult sts.

Metastatic soft tissue sarcoma, an analysis of systemic therapy and impact on survival.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 10545-10545 ◽  
Author(s):  
Samuel John Harris ◽  
Marco Maruzzo ◽  
Khin Thway ◽  
Omar Al-Muderis ◽  
Robin Lewis Jones ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy ◽  
Impact On Survival ◽  
Metastatic Soft Tissue Sarcoma

scholarly journals Update on Systemic Therapy for Advanced Soft Tissue Sarcoma

2020 ◽  
Vol 26 ◽  
Author(s):  
A. Smrke ◽  
Y. Wang ◽  
C. Simmons
Keyword(s):  
Clinical Trials ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy ◽  
English Language ◽  
Standard Of Care ◽  
Current Evidence ◽  
First Line ◽  
First Line Therapy ◽  
Full Text Review

Background: Soft tissue sarcoma (STS) is a rare group of mesenchymal neoplasms which contains over 50 heterogenous subtypes.  There have been great efforts to increase the understanding of treatment of advanced STS (unresectable or metastatic disease). We wished to determine if outcomes for patients with advanced STS have improved over time, and to assess the current evidence for systemic therapy. Methods: We performed a scoping review to evaluate the contemporary evidence for systemic treatment of advanced soft tissue in adults (>18 years old). Phase I, II, and III studies of systemic therapy for advanced STS published in the English language were included. After abstract and full text review of 77 studies, 62 trials met inclusion criteria.  Results: The number of clinical trials conducted and published in advanced STS has increased over the last 30 years. Although median OS has increased, attempts at improving first line therapy through dose intensification, doublet chemotherapy or alternative backbones have not been successful. The optimal therapy beyond anthracyclines remains a challenge, especially given the inherent heterogeneity of grouping multiple STS subtypes within clinical trials. However, increasing numbers of agents are being studied and several studies had shown isolated PFS or OS benefit.  Conclusions: First line anthracycline systemic therapy remains the standard of care for advanced STS.  However, choice of subsequent therapy beyond anthracyclines remains challenging. Novel systemic therapies, using molecular diagnostics to direct therapy, subtype specific trials and learning from real world retrospective data are all important in improving outcomes for patients with advanced STS.

scholarly journals Systemic Therapy for Soft Tissue Sarcoma: Proposals for the Optimal Use of Pazopanib, Trabectedin, and Eribulin

2017 ◽  
Vol 34 (7) ◽  
pp. 1556-1571 ◽  
Author(s):  
Akira Kawai ◽  
Kan Yonemori ◽  
Shunji Takahashi ◽  
Nobuhito Araki ◽  
Takafumi Ueda
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Systemic Therapy
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