Clinical benefits of later line trabectedin and eribulin treatment for soft tissue sarcoma (STS) after pazopanib treatment from Nishinomiya Sarcoma...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Soft Tissue Sarcomas
Presenter Hiroyuki Narahara
Citation Annals of Oncology (2018) 29 (suppl_9): ix124-ix128. 10.1093/annonc/mdy443
Authors H. Narahara1, M. Morimoto2, E. Tanaka2, S. Ueda2, Y. Yasunaga2, Y. Inui2, K. Takahashi3, S. Kawata2
  • 1Clinical Research Center, Nishinomiya Hospital, 662-0918 - Nishinomiya/JP
  • 2Internal Medicine, Nishinomiya Hospital, Nishinomiya/JP
  • 3Sarcoma Center, International University of Health ana Welfare, Mita Hospital, Tokyo/JP

Abstract

Background

We conducted a retrospective analysis on trabectedin and eribulin for STS in order to investigate the clinical comparison of these two treatments after pazopanib treatment.

Methods

In this study, patients with metastatic STS treated with pazopanib from November 2012 to November 2017, consecutively, some 187 pts, were retrospectively analyzed as data of the NSCS. Trabectedin (T) was administered intravenously 1.2mg/m2 (day1, q21 days) for 24 hours through the CV port in an overnight inpatient setting. Eribulin (E) was administered intravenously 1.4mg/m2 (day1.8, q21 days) in an outpatient setting. For genomic analyses, we used Strelka and Virmid analysis software. BRCA locus were validated by multiplex ligation-dependent probe amplification and Sanger sequencing.

Results

Seventy-one pts treated with these two drugs were identified. T: Forty two pts. Median age was 53 years old (range 32-76), 31 females and 11 males. RR was 9.5% and DCR was 33.3%. Median OS reached 9.1 months (95% CI: 3.68-17.22). According to primary site, OS was better with chest wall, retroperitoneal and uterine origin (18.2, 13.6, 11.7 months, respectively) than that seen with small intestine and heart origin (3.8, 1.7 months, respectively, p = 0.0149). According to histology, endometrial sarcoma, liposarcoma and leiomyosarcoma (17.2, 13.6, 11.7 months, respectively) were better than that of angiosarcoma and alveolar soft part sarcoma (1.7, 1.1 months, p = 0.0029). PR/SD was better than PD (9.1, 17.2, 3.8 months, respectively, p = 0.0101). Though T was approved for STS in decreased dose in Japan, rhabdomyolysis was frequently observed in 5 pts (11.9%). Four pts showed rhabdomyolysis within 2 cycles, but one patient did after 9 cycles. E: Twenty-nine pts. Median age was 62 years old (range 33-76), 22 females and 7 males. Median OS reached 13.8 months (95%CI: 8.02-NR). RR was 18% and DCR was 36%. Eleven pts received both drugs and showed OS 13.7 months (vs single drug 6.3 months). Finally, genomic analyses revealed that inherited BRCA2 mutations and tumor hemi/homozygosity shows shorter OS.

Conclusions

Trabectedin after pazopanib should be administered carefully for Japanese pts. Further genome-wide examinations are warranted.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Hiroyuki Narahara.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.