1415O - Outcome of first-line treatment of elderly advanced soft tissue sarcoma (STS) patients: a pooled analysis of eleven EORTC Soft Tissue and Bone Sarc...

Date 29 September 2014
Event ESMO 2014
Session Sarcoma
Topics Anti-Cancer Agents & Biologic Therapy
Soft Tissue Sarcomas
Geriatric Oncology
Presenter Winette T.A. van der Graaf
Citation Annals of Oncology (2014) 25 (suppl_4): iv494-iv510. 10.1093/annonc/mdu354
Authors W.T.A. van der Graaf1, A. Le Cesne2, O. Mir2, H. Gelderblom3, A. Italiano4, S. Marréaud5, I. Judson6, S. Litière7
  • 1Department Of Medical Oncology/452, Radboud University Medical Centre Nijmegen, 6500 HB - Nijmegen/NL
  • 2Medical Oncology, Institut Gustave Roussy, Villejuif/FR
  • 3Medical Oncology, Leiden University Medical Center (LUMC), NL-2300 RC - Leiden/NL
  • 4Medical Oncology, Institut Bergonié, Bordeaux/FR
  • 5Medical Department, EORTC HQ, 1200 - Brussels/BE
  • 6Sarcoma Unit, Royal Marsden Hospital, GB- SW3 6JJ - London/GB
  • 7Data Center, EORTC, Brussels/BE

Abstract

Aim

Half of patients (pts) diagnosed with STS are older than 65 years, yet little data is available on survival of elderly pts with metastatic disease receiving standard chemotherapy. We therefore investigated the outcome of STS pts, treated with standard chemotherapy within EORTC trials.

Methods

Pts who had an indication for systemic treatment because of locally unresectable or metastatic disease were evaluated. The EORTC database contains information on 2636 pts who did not receive prior chemotherapy and who were treated with doxorubicin (DOX), epirubicin (EPI), ifosfamide (IFO) or a combination of doxorubicin and ifosfamide (DOX-IFO) in the context of 11 EORTC advanced STS clinical trials. Of these, 274 pts were older than 65 years. The end points of interest for this analysis are overall survival (OS), progression free survival (PFS) and response rate (RR).

Results

274 pts were eligible. Median age of the elderly pts was 68 years (IQR 67-70), with a maximum of 80 years. Almost half (49%) had performance status (PS) 1, 12% had PS of 2 or more; 27% had histological grade 3. The most frequently reported histology was leiomyosarcoma (LMS) (39%). For 48% of pts disease involved the primary site of origin, 47% had lung metastases, 19% liver metastases, 8% bone metastases and 26% had lesions of other origin. 91 (33%) pts were treated with DOX, 43 (16%) with EPI, 26 (9%) with IFO and 114 (42%) with DOX-IFO. Median OS of the elderly pts was 9.8 months(mo) (95% CI: 6.2-11.9) for DOX, 9.9 mo (95% CI: 5.9-11.8) for EPI, 9.7 mo (95% CI: 2.9-14.4) for IFO, 12 mo (95% CI: 6.6-14.9) for DOX-IFO. Median PFS was 2.8 mo (95% CI: 2.0-4.0) for DOX, 3.8 mo (95% CI 1.4-6.2) for EPI, 2.2 mo (95% CI: 1.4-3.8) for IFO and 5.2 mo (95% CI: 3.1-6.4) for DOX-IFO. 42 (15.4%) pts achieved a response (complete or partial). In comparison, median OS of the 2363 pts aged less than 65 (median 49 years, IQR 37-57) was 11.5 mo (95% CI: 10.3-12.4), 11.2 mo (95% CI: 9.3-12.2), 11.1 mo (95% CI: 10.2-12.6) and 13.2 mo (95% CI: 12.4-14.2), respectively. Median PFS was 3.5 mo (95% CI: 3.1-4.1), 2.9 mo (95% CI: 2.3-3.4), 2.8 mo (95% CI: 2.4-3.1) and 6.2 mo (95% CI: 5.6-6.6) respectively.

Conclusions

The outcome of elderly pts is slightly worse. New strategies for elderly pts with advanced STS are urgently needed. These results can be used as benchmarks for developing new trials in this age group.

Disclosure

All authors have declared no conflicts of interest.