1487P - Natural history of Alveolar Soft Part Sarcoma (ASPS): impact of Brain Metastases and Role of Anti-Angiogenic Therapies (AAT)

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Soft Tissue Sarcomas
Sarcoma
Presenter Gabriel Malouf
Citation Annals of Oncology (2017) 28 (suppl_5): v521-v538. 10.1093/annonc/mdx387
Authors G. Malouf1, G. Beinse1, O. Mir2, J. Adam3, P. Terrier3, J. Spano1, C. Honore4, A. Italiano5, J. Coindre6, J. Blay7, A. Lecesne8
  • 1Medical Oncology, Groupe Hospitalier Pitié Salpetriere, 75651 - Paris/FR
  • 2Department Of Cancer Medicine, Gustave Roussy Cancer Campus, 94800 - Villejuif/FR
  • 3Department Of Pathology, Gustave Roussy Cancer Campus, 94800 - Villejuif/FR
  • 4Department Of Surgical Oncology, Gustave Roussy Cancer Campus, 94805 - Villejuif/FR
  • 5Early Phase Trials And Sarcoma Units, Institute Bergonié, 33076 - Bordeaux/FR
  • 6Department Of Biopathology, Institute Bergonié, 33076 - Bordeaux/FR
  • 7Department Of Adult Medical Oncology, Centre Leon Berard, 69008 - Lyon/FR
  • 8Department Of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif/FR

Abstract

Background

ASPS is a rare sarcoma subtype with clinical specificities, such as an indolent behavior, brain metastasis and resistance to doxorubicin. AAT have shown clinical activity in this setting, but little is known on the optimal therapeutic strategy, and the management of brain metastasis (BM).

Methods

We retrospectively analyzed patients (pts) treated in 3 referral centers of the French Sarcoma Group. Factors associated with BM development and overall survival (OS) were analyzed. In addition, progression-free survivals (PFS) under AAT in patients with and without BM were reported.

Results

We identified 75 pts [median age at diagnosis: 23 (5-96 years), 61% females]. Among those, 31 (41%) pts had documented synchronous lung metastasis (LM), and none had BM. Median OS in pts with localized and metastatic disease were 279 months, (95% CI, 279-NR) and 74 months (95% CI, 62-144) (Log-rank, p = 0.002), respectively. Only surgical complete resection (R0) was associated with better OS in localized disease (HR = 4.3; (95% CI, 1-19.3), p = 0.056). Fifty-two (69%) pts had documented LM in the course of the disease; among those, 13 (17%) pts developed BM within a median interval of 35 months (95% CI, 17-48) from LM. Initial tumor size was associated with BM-free-survival (≥5cm vs

Conclusions

These data highlight the indolent course of the disease leading to BM, which turned a shift in the course of the disease, along with limited efficacy of AAT in this setting. Furthermore, they suggest that the appropriate timing for AAT introduction has to be discussed in an individual basis considering the PFS/OS ratio in pts with metastatic disease.

Clinical trial identification

Legal entity responsible for the study

Institut Gustave Roussy

Funding

None

Disclosure

G. Malouf: Consulting: Pfizer, BMS, Novartis Research grant: Pfizer, Novartis. O. Mir: Speaker: Lilly, Roche Consulting: Amgen, Astra-Zeneca, Bayer, Blueprint, BMS, Lilly, Novartis, Pfizer, Roche, Servier. J-P. Spano: conflict of interest with the following companies: Pfizer, BMS, MSD, Roche. J-Y. Blay: Research support: Novartis, Roche, GSK, Bayer, Pfizer. A. Lecesne: Honoraria: Amgen, Novartis, Pharmamar, Pfizer, Lilly. All other authors have declared no conflicts of interest.